Social participation reduces isolation among Japanese older people in urban area: A 3-year longitudinal study

Associations between self-perceptions of aging and social functioning in older adults: An analysis based on health and retirement study data

OBJECTIVES

Self-perception of aging (SPA) and social functioning are two important variables in the process of healthy aging, but the relationship between them is still unclear. This study aimed to explore the association between SPA and social functioning in older adults.

METHODS

We conducted a longitudinal study utilizing data from the Health and Retirement Study. The sample comprised individuals aged 50 and above. Socio-demographic, psychosocial, and lifestyle information of study participants was systematically collected at baseline (2012 and 2014) and during follow-up four years later (2016 and 2018). SPA was measured using a scale assessing individuals' attitudes toward their aging process. Social functioning was evaluated through 22 questions, reflecting individuals' abilities to engage in and perform various roles and tasks in their daily lives. Multilevel modeling was employed to analyze the relationship between SPA and social functioning. Differences in social functioning changes among various SPA groups were assessed through the Generalized Estimating Equations methodology.

RESULTS

The study included 8,454 participants with an average age of 68.3 years (SD = 9.92). The multilevel model revealed a significant correlation between SPA and social functioning (β = 0.131; P < 0.001). This relationship persisted after adjusting the model (β = 0.088; P < 0.001). Generalized Estimating Equations indicated noteworthy differences in social functioning changes among distinct SPA groups (P = 0.034).

DISCUSSION

Positive SPA is associated with the healthy social functioning of older adults. Healthcare providers could target modifiable aspects of SPA to enhance the social function of older adults and promote successful aging.

Exploring the use of powered mobility devices and occupational participation for people with obesity

BACKGROUND

The increasing prevalence of obesity is a global issue with the World Health Organization estimating that more than 650 million adults are impacted by obesity. Those living with obesity are impacted by both physical and psychological issues. The physical consequences of living with obesity can lead to decreased mobility and reduced occupational participation. The aim of this research is to understand how the use of a powered mobility device influences occupational participation and quality of life from the perspective of people with obesity.

METHOD

Semi-structured qualitative interviews (n = 7) were undertaken with a phenomenological approach to gain an understanding of the lived experience of using a powered mobility device.

RESULTS

Thematic analysis occurred resulting in inter-connected themes that describe the positive experiences associated with using a powered mobility device: (1) autonomous mobility; (2) enhanced occupational participation; and (3) improved self-efficacy creates increased confidence in relation to participation. In addition, two themes emerged that were barriers to usage of powered mobility devices: (4) physical environmental barriers and (5) difficulty transporting the powered mobility device.

CONCLUSION

For those with obesity, a powered mobility device provided autonomous mobility allowing them to engage in an increased range of activities. This was hampered by physical environmental barriers and difficulties transporting the powered mobility device. Further research is required to verify the results of this study with a wider population and to explore the benefits and barriers to use of a powered mobility device in the home and community.

Testing a frailty prevention program for older men during COVID-19: A 2-year mixed-methods pilot study

BACKGROUND

Frailty is a syndrome related to declining functioning attributed to aging. As a reversible, often improved condition, preventive measures for frailty can be effective.

OBJECTIVE

This study aimed to evaluate a frailty prevention program for older men comprising face-to-face meetings and an original social mobile application. We also examined the effect of COVID-19-associated social isolation on the implementation of this program.

METHODS

We conducted a mixed-methods pilot study featuring a single group before and after comparison of 11 man participants, ≥65 years, living in Japanese cities with a spouse or relatives. Program outcome measures included frailty, loneliness, grip strength, step count and mental health status. Process evaluation considered the experience of participants through a semi-structured interview.

RESULTS

The intervention period included an interval of self-isolation owing to the spread of COVID-19. Among the outcomes, grip strength decreased after intervention. No significant negative changes were observed in other items. Themes emerging from participant experiences with the program included 'Cooperation with researchers and contributing to research', 'Greater awareness of health', 'Interest in and experience of "newness"', 'Hesitation over active engagement', 'Casual ties with members' and 'Relationships that do not breach personal boundaries'.

CONCLUSIONS

Although the COVID-19 pandemic overlapped with the intervention, participants maintained their mental health. The program was a novel, stimulating experience for older men and demonstrated the usefulness of information and communication technology in supporting their social activities.

IMPLICATIONS FOR PRACTICE

As a community health nursing initiative for older people, we propose activities that combine group and online support. Frailty prevention programs for older men must contain content that stimulates their interests, such as 'health' and 'newness'.

Impact of combinations of subscale declines in higher-level functional capacity on 8-year all-cause mortality among community-dwelling older Japanese adults

BACKGROUND

The frequency of combined declines in domains of multi-faceted frailty and their impact on adverse health outcomes have not been adequately investigated. We aimed to examine the association between combined subscale declines in higher-level functional capacity and 8-year all-cause mortality among community-dwelling older Japanese individuals and the impact of multi-faceted frailty on mortality.

MATERIALS AND METHODS

We administered a questionnaire to 7015 community-dwelling older adults aged 65-85 years. The higher-level functional capacity of the 3381 respondents was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Subscale decline was defined as (1) none, (2) only social role (SR), (3) only intellectual activity (IA), (4) SR and IA, (5) only instrumental activities of daily living (IADL), (6) IADL and SR, (7) IADL and IA, and (8) all. Associations between combined subscale declines and mortality were examined using adjusted Cox proportional hazards models. Follow-up was conducted from October 1, 2012, to death or November 1, 2020.

RESULTS

The mortality rate was 16.7/1000 person-years. Moreover, 44% of respondents had declined SR, and half of them had multiple declines. Compared with no decline, SR (adjusted hazard ratio [HR]: 1.49, 95% confidence interval [CI]: 1.14-1.93), SR and IA (HR: 1.59, 95% CI: 1.16-2.17), IADL and SR (HR: 1.97, 95% CI: 1.31-2.99), and all-domain (HR: 2.72, 95% CI: 1.98-3.74) declines were significantly associated with higher mortality risks.

CONCLUSIONS

Overlapping SR and IADL declines increased mortality risk, suggesting the importance of measuring social frailty and overlapping physical and social frailty.

Social interaction trajectories and all-cause mortality in older adults: the Otassha study

Introduction

This longitudinal study aimed to identify aging trajectory patterns of social interaction by sex and determine the association between these patterns and all-cause mortality.

Methods

Participants were 4,065 community-dwelling older adults (1849 men) in Japan, aged 65-89 years, who responded twice or more to a mail survey conducted between 2012 and 2020. Social interaction was examined through the frequency of face-to-face and non-face-to-face contact with non-resident family and friends. The aging trajectories of the social interaction scores were identified using group-based trajectory modeling.

Results

Two groups were identified among both men and women. Among men with high-frequency interaction, a rapid decrease in the frequency of social interaction was observed after 80 years of age. Conversely, among women, the frequency tended to remain the same, even after 80 years of age. The social interaction score among those aged 65 years in the low-frequency group was approximately 4 points for men and 6 points for women. Among men, no decrease was observed; however, it tended to decline after 85 years of age among women. Among men, the factors associated with the low-frequency group were instrumental activities of daily living score, perceived financial status, and social participation, while among women, they were self-rated health and social participation. The adjusted hazard ratio in the low-frequency group for all-cause mortality was 1.72 (95% confidence interval, 1.27-1.72) for men and 1.45 (95% confidence interval, 0.98-2.14) for women.

Discussion

In the low-frequency group, men had a higher risk of all-cause mortality than women. Daily social interaction from mid-age is important to reduce the risk of social isolation and all-cause mortality in later life.

The impact of spouse health on social participation of older adults in China: Evidence from the CLHLS

BACKGROUND

China is dealing with a serious aging issue. Social participation is essential for active aging. The health status of spouses is intertwined with the trajectory of the social function of the elderly.

OBJECTIVES

This study examined the association between spouse health and social participation among older Chinese adults. The study also explored the mediating role of loneliness and anxiety between spousal health and social participation.

METHODS

The analytic sample included 6125 adults aged 60 years and above. Prospective data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). First, we described basic socio-demographic information about the sample. Secondly, Spearman's correlation analysis was used to determine whether correlations existed between spousal health, loneliness, anxiety, and social participation. Finally, mediation analysis was run using the SPSS macro PROCESS program.

RESULTS

Spousal health, loneliness, anxiety, and social participation were significantly correlated (P < 0.01). Spousal health could not only have a direct positive impact on social participation in older adults (β = 0.239, 95 % CI: 0.120, 0.359), but also indirectly on social participation through three pathways: an independent mediating effect of loneliness (β = 0.020, 95 % CI: 0.009, 0.034), an independent mediating effect of anxiety (β = 0.018, 95%CI: 0.009, 0.032), and a chain mediating effect of loneliness and anxiety (β = 0.004, 95%CI: 0.002, 0.007).

CONCLUSION

This study suggests paying more attention to elderly couples and decreasing the negative consequences of changes in spousal health.

The trajectory of psychological well-being during the COVID-19 pandemic and its association with health-promoting coping behavior among Japanese community-dwelling older adults: The Otassha Study

This study aims to identify the trajectory of psychological well-being during the COVID-19 pandemic among community-dwelling older adults and to clarify the association between coping behavior in the early stage of the pandemic and the trajectory of psychological well-being. The study was based on a cohort study, known as "the Otassha Study." We administered three follow-up surveys to 720 older adults who participated in the survey in October 2019 (T0): T1: June 2020, T2: October 2020, and T3: October 2021. Furthermore, we assessed coping behavior in T1 via a self-developed questionnaire comprising 10 items. Psychological well-being was assessed by the WHO-5 Well-Being Index (score range: 0 to 25) in all surveys. The trajectories of psychological well-being were identified by group-based trajectory modeling. The association between coping behaviors and trajectory patterns was assessed using multinomial logistic regression analysis. Furthermore, among the 508 participants who participated in the follow-up survey two times or more, three patterns of the trajectory of psychological well-being were identified: heavily decreased group (n = 39), decreased group (n = 352), and increased group (n = 39). "Walking" as a coping behavior had a significantly higher odds ratio (OR) to be in the increased group (OR = 2.32, 95 % confidence interval (CI) 1.06-5.05, p = 0.035) compared to the heavily decreased group. "Conversations with family living together" had a slightly higher OR to become an increased group (OR = 1.96, 95 % CI: 0.87-4.41, p = 0.106), and "actively gathering information on COVID-19" had a slightly lower OR to become the decreased group (OR = 0.53, 95 % CI: 0.26-1.06, p = 0.072) compared to the heavily decreased group. The results of this study suggest how maintaining health in the early stage of the pandemic had a great influence on the long-term health status.

Social isolation and health among family caregivers of older adults: Less community participation may indicate poor self-reported health

Social isolation is associated with adverse health outcomes in the general older adult population, but little is known about indicators of social isolation in family caregiver populations. This cross-sectional study examined the prevalence of social isolation in the 2015 National Survey of Caregiving. Using the Convoy Model of social relations, a life-course social support framework, we also examined associations between social isolation and caregiver self-reported health. Using multiple ordinal logistic regression models, we examined social isolation - operationalised with a five-item summative measure and, alternatively, with each social isolation item - as a predictor of self-reported general health status. On the dichotomised summative measure, 24.74% (n = 2,175) were more isolated. Younger caregivers were more isolated (M = 56.77 years, SE = 0.76) compared with those who were not (M = 60.86 years, SE = 0.41). Self-reported general health was as follows: 4.93% poor; 15.67% fair; 25.62% good; 34.81% very good and 18.97% excellent. Less social isolation was associated with higher odds of better self-reported health (Adjusted odds ratio [AOR] = 1.19; CI = 1.05-1.35). Of the individual social isolation indicators, only a lack of community participation was associated with higher odds of worse self-reported health (AOR = 1.57; CI = 1.25-1.97). Social isolation and particularly community participation were associated with caregiver health status. It may be necessary for healthcare providers to consider these factors in caregiver health assessments. Future research is recommended to understand the consequences of various social isolation indicators in diverse samples including younger caregivers.

Association of social disengagement with health status and all-cause mortality among community-dwelling older adults: evidence from the Otassha study

This study examined the impact of disengagement on health status and mortality among community-dwelling older adults in Japan. Disengagement from society was operationally defined as dropping out of a longitudinal survey. A follow-up mail survey was conducted, in 2014, among respondents (n = 3696) of the baseline mail survey. Step-by-step follow-up surveys (FLs), including simplified mail, postcard, and home-visit surveys, were sent to participants who did not respond. Disengagement levels were defined according to the response to the FLs as zero (mail survey), low (simplified mail survey), middle (postcard survey), high (home-visit survey), and highest (non-responders to the home-visit survey). After adjusting for health status at baseline, the proportion of respondents self-rated as "not healthy" during FLs was significantly higher in the high-level than in the zero-level group. The proportion of respondents reporting a "once a week or less" frequency of going outdoors during FLs was significantly higher in the low-, middle-, and high-level groups than in the zero-level group. Mortality rates were significantly higher in the high and highest levels than in the zero-level group. Higher disengagement levels increased the risk of lower health status and mortality, suggesting an urgent need to prevent societal disengagement among older adults.

Determinants of new participation in sports groups among community-dwelling older adults: Analysis of a prospective cohort from The Otassha Study

Participation in sports groups has health benefits for older adults, such as preventing functional limitations and social isolation. Encouraging participation in sports groups may be an important means of health promotion in older adults. However, there is insufficient research on the determinants of new participation in sports groups to consider effective interventions to promote participation in these groups. We investigated this using data from a 1-year prospective study. Data were obtained from "The Otassha Study" that assessed a cohort of community-dwelling older adults living in an urban area of Japan. Of 769 older adults who participated in a baseline health survey in 2018, 557 participated in a follow-up survey in 2019. We excluded 184 individuals who already participated in sports groups at baseline and 36 with missing data. Participation in sports groups was defined as that occurring more than once a week. Logistic regression analysis was used to identify the determinants of new participation in sports groups, with sociodemographic factors, lifestyle habits, physical functions, cognitive functions, psychological factors, and social factors as independent variables. Forty-one (12.2%) individuals participated in sports groups at follow-up. In the multiple adjusted logistic regression model, new participation in sports groups was significantly associated with female sex (odds ratio [OR] = 5.57, 95% confidence interval [CI]: 1.61‒19.26), engagement in regular exercise (OR = 2.23, 95%CI: 1.03‒4.84), and having a large social network (OR = 1.12, 95%CI: 1.04‒1.20). Physical functions were not associated with new participation. Determinants of new participation were lifestyle habits and social factors, rather than physical functions. Intervention through social networks may be effective in encouraging new participation in sports groups, which, in turn, may facilitate healthy aging.

Prevalence and determinants of social isolation among elderly in an urban slum of Raipur city-A community based cross-sectional study

BACKGROUND

Social isolation is a predictor of mortality and morbidity, as well as an outcome of many health-related predictors. The aim of this study was to estimate the prevalence of social isolation among the elderly and to study factors associated with it.

METHODS

This was an analytical cross-sectional study conducted in Urban Field Practice Area of a tertiary care teaching hospital in Chhattisgarh, India among elderly more than or equal to 60 years of age selected using random sampling. The data was collected in a sample of 400 elderly by face-to-face interview using predesigned, pretested, and semi-structured proforma that included Lubben Social Network Scale-6 (LSNS-6) and analyzed using Stata v16.

RESULTS

The prevalence of social isolation was 34.3%; highest among those 65-74 years of age (44.5%) and females (56.9%). Increasing age, elderly with less than three family members, lower socio-economic status, no children and financial dependence among socio-demographic factors; insufficient time with children, lack of emotionally attachment and conflict in the family among family support factors; lack of social participation, poor perception of health and feeling lonely among psychosocial factors; lack of physical exercise, spiritual activity and sound sleep among lifestyle factors; and presence of active complaints, raised blood pressure and being anemic among medical factors were significantly associated with social isolation. Overall, the independent predictors of social isolation in elderly were age ≥75 years, lack of participation in social functions, feeling lonely and lack of sound sleep.

CONCLUSION

The prevalence of social isolation among elderly from an urban slum in India was high and the existing evidence show a rising trend. Social isolation assessment and use of LSNS-6 by healthcare providers should be incorporated into elderly care at primary healthcare delivery points across the country.

Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Objectives

The present study investigated the association between religious and spiritual (RS) practices with the prevalence, severity, and incidence of mental health problems in older adults.

Methods

We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed RS using valid scales and questions from valid scales, and mental health according to validated multidimensional or specific instruments. Studies were retrieved from MEDLINE, LILACS, SCOPUS, CINAHL, and AgeLine databases until July 31, 2021. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on the log odds ratio (OR) and Z-scores. This study is registered on PROSPERO.

Results

One hundred and two studies that investigated 79.918 community-dwellers, hospitalized, and institutionalized older adults were included. Results indicated that high RS was negatively associated with anxiety and depressive symptoms, while a positive association was observed with life satisfaction, meaning in life, social relations, and psychological well-being. Specifically, people with high spirituality, intrinsic religiosity, and religious affiliation had a lower prevalence of depressive symptoms. In relation to longitudinal analysis, most studies supported that high RS levels were associated with a lower incidence of depressive symptoms and fear of death, as well as better mental health status.

Conclusion

Findings of the present study suggest that RS are significantly associated with mental health in older adults. People with high RS levels had a lower prevalence of anxiety and depressive symptoms, as well as reported greater life satisfaction and psychological well-being, better social relations, and more definite meaning in life. Data provided by an increasing number of longitudinal studies have supported most of these findings.

Effect of socioeconomic status on the physical and mental health of the elderly: the mediating effect of social participation

BACKGROUND

Previous studies have demonstrated the effect of socioeconomic status on the health status of the elderly. Nevertheless, the specific dimensions of the effect and the mechanism await further investigation. In this study, socioeconomic status was divided into three dimensions and we used social participation as the mediation variable to investigate the specific path of effect.

METHODS

Using the 2018 Waves of Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset, a total of 10,197 effective samples of the elderly over 65 years old were screened out. Socioeconomic status included income, education level, and main occupation before retirement. The physical health and mental health of the elderly was measured by the Instrumental Activities of Daily Living Scale and the Minimum Mental State Examination, respectively. The social participation of the elderly was the mediation variable, including group exercise, organized social activities and interacting with friends. Omnibus mediation effect analysis was adopted to examine the mediation effect and mediation analysis was completed using the SPSS PROCESS program.

RESULTS

First, the results showed that when the income gap between the elderly reached a certain level, there was a significant difference in health status. Significant differences existed in health status amongst with different education levels. There was no sufficient evidence to show that occupation has a significant effect on the physical health. But when the dependent variable was mental health, the effect was significant. Second, group exercise mediated 64.11% (a_ib = 0.24, 95% CI [0.17,0.3]) and up to 20.44% (a_ib = 0.12, 95% CI [0.07,0.17]) of the disparity in physical and mental health due to income gap, respectively. And it could mediate the effect up to 56.30% (a_ib = 0.62, 95% CI [0.52,0.73]) and 17.87% (a_ib = 0.50, 95% CI [0.4,0.61]) of education on physical and mental health status, respectively. The proportion of relative mediation effect of occupation was up to 28.74% (a_ib = 0.19, 95% CI [0.13,0.25]) on mental health. Interacting with friends mediated only on the path that the education affected the health status of the elderly. The proportion was up to 33.72% (a_ib = 0.29, 95% CI [0.16,0.44]). The relative mediation effect of organized social activities on the health gap caused by income or education level gap was significant at some levels. The proportion was up to 21.20% (a_ib = 0.33, 95% CI [0.26,0.4]).

CONCLUSION

The SES of the elderly including relatively large income gap, different education levels and occupational categories could indeed have a significant effect on health status of the elderly, and the reason why this effect existed could be partly explained by the mediation effect of social participation. Policymakers should pay more attention to the social participation of the elderly.

Oral Status and Dementia Onset: Mediation of Nutritional and Social Factors

Some modifiable risk factors for dementia are closely related to oral health. Although eating and speaking abilities are fundamental oral functions, limited studies have focused on the effect of malnutrition and lack of social interaction between oral health and dementia. We investigated the mediating effects of nutritional and social factors on the association between the number of teeth and the incidence of dementia. This 6-y cohort study used data from the Japan Gerontological Evaluation Study targeting older adults aged 65 y and above. The number of teeth (exposure) and covariates in 2010 (baseline survey), mediators (weight loss, vegetable and fruit intake, homeboundness, social network) in 2013, and the onset of dementia (outcome) between 2013 and 2016 were obtained. The Karlson-Holm-Breen mediation method was applied. A total of 35,744 participants were included (54.0% women). The mean age at baseline was 73.1 ± 5.5 y for men and 73.2 ± 5.5 y for women. A total of 1,776 participants (5.0%) had dementia during the follow-up period. There was a significant total effect of the number of teeth on the onset of dementia (hazard ratio, 1.14; 95% CI, 1.01-1.28). Controlling for nutritional and social mediators, the effect of the number of teeth was reduced to 1.10 (95% CI, 0.98-1.25), leaving an indirect effect of 1.03 (95% CI, 1.02-1.04). In the sex-stratified analysis, the proportion mediated by weight loss was 6.35% for men and 4.07% for women. The proportions mediated by vegetable and fruit intake and homeboundness were 4.44% and 4.83% for men and 8.45% and 0.93% for women, respectively. Furthermore, the proportion mediated by social networks was 13.79% for men and 4.00% for women. Tooth loss was associated with the onset of dementia. Nutritional and social factors partially mediated this association.

Older adults' experiences of maintaining social participation: Creating opportunities and striving to adapt to changing situations

BACKGROUND

Social participation concerns the possibility of engaging in activities in interaction with others or society at large and contributes to the health and well-being of older adults. In contrast, a lack of social participation is associated with loneliness. It is, therefore, important to understand what strategies older adults use to maintain social participation.

AIM

To explore and describe older adults' experiences of maintaining social participation.

MATERIALS AND METHODS

Nine older adults, aged 69-92 years, participated in interviews that were analysed through qualitative content analysis.

RESULTS

The overall findings reflect how older adults create opportunities for social participation by developing strategies and striving to adapt to changing situations, emphasizing how maintaining social participation is an active process. Preserving social participation requires motivation and an effort to take initiative to cultivate social relations, maintain community bonds, engage in social events and activities and stay connected with society.

CONCLUSIONS AND SIGNIFICANCE

These results may extend our understanding of strategies that older adults use, as well as the challenges they face when striving to adapt to new circumstances. This study may have implications for the practice of how to support older adults' social participation.

The impact of a power mobility device on occupational participation and quality of life for people with chronic diseases: A scoping review

Introduction

The aim was to explore occupational participation and quality of life (QoL) for power mobility device users with chronic disease.

Methods

Arksey and O’Malley’s framework for scoping reviews was used. Six data bases were searched using keywords: wheelchair, scooter, QoL and participation. Data were extracted with coding and thematic analysis performed.

Results

Forty-one articles met the inclusion criteria. An overarching theme of enhanced QoL was identified with subthemes of (i) independence, (ii) enabling participation in instrumental activities of daily living, (iii) enhanced social participation and leisure, (iv) environmental barriers to occupational participation, (vi) power mobility device (PMD) performance concerns impacting occupational participation and (vii) overcoming risk of harm through PMD training.

Conclusion

The scoping review identified a heterogeneity of study designs and outcome measures, which makes comparison between studies difficult. For people with chronic diseases, PMDs improve independence in occupational participation, particularly in IADL, social participation and leisure. Unfortunately, improved QoL was often inferred, without the use of an outcome measure. Areas which impacted occupational participation for PMD users were environmental barriers and a lack of PMD training. Further research is needed to understand the impact of a PMD on QoL and occupational participation for those with chronic disease.

Social Isolation, Loneliness and Their Relationships with Mental Health Status in South Korea

OBJECTIVE

This study aims to investigate the prevalence and psychological impact of social isolation and loneliness in South Korea. Loneliness and social isolation have been regarded as a risk to both physical and mental health. However, most studies have focused on the elderly; hence, there are limited studies on the characteristics of socially isolated or lonely people considering age.

METHODS

A sample of 1,700 participants was selected from three major cities in South Korea. In-person interviews were conducted to evaluate loneliness, social isolation and mental health status.

RESULTS

Among the participants, the prevalence of social isolation and loneliness was 17.8% and 4.1%, respectively. Males decreased the odds of loneliness (AOR 0.49, 95% CI=0.28-0.87), while increasing the odds of social isolation (AOR 1.44, 95% CI=1.12-1.86) after adjusting for age and sex. Greater depressive and social phobic symptoms were associated with increased odds of loneliness and social isolation.

CONCLUSION

Social isolation and loneliness are prevalent among Koreans and associated with depression, social phobic symptoms, and suicidality. This study provides a foundation for further research to investigate nationwide prevalence and a more in-depth analysis of loneliness and social isolation.

Experiences With Social Participation in Group Physical Activity Programs for Older Adults

Little is known about how social participation can be facilitated among older adults in group physical activity and its psychosocial benefits that contribute to successful aging. This study aimed to understand older adults' experiences with social participation in group physical activity programs. Using interpretive description methodology, 16 observations, eight focus groups, and two interviews with participants unable to attend focus groups were conducted with adults 55 years and older attending programs across four recreation facilities. Group programs were found to influence social participation through (a) a meaningful context for connecting and (b) instructors' expectations of social interaction. Social participation in these programs addressed psychosocial needs by (c) increasing social contact and interaction, (d) fostering social relationships and belonging, and (e) promoting regular engagement. Training for instructors should include balancing the physical aspects of program delivery with the social, while also considering older adults' diverse needs and preferences for social interaction.

The Effect of Labor and Relationship Exclusions on Older Korean Men with Depression

To manage depression of older men, it is necessary to identify factors that influence depression and improve them. This study used the Korean Aging Longitude Research to understand the effects of labor exclusion and relationship exclusion on depression in Korean male seniors aged 65 and older. According to research on the effect of labor exclusion and relationship exclusion on depression, depression in the case where labor was excluded was 1.69 times higher in 2014, 1.65 times higher in 2016, and 1.93 times higher in 2018 compared to the case where labor was not excluded. Depression in the case where relationship was excluded was 2.94 times higher in 2014, 3.15 times higher in 2016, and 2.57 times higher in 2018 compared to the case where relationship was not excluded. Depression in the case where labor and relationship were both excluded was 3.00 times higher in 2014, 3.23 times higher in 2016, and 2.81 times higher in 2018 compared to the case where neither labor nor relationship was excluded. Since labor exclusion and relationship exclusion have a big influence on depression in older men, it is necessary to establish plans for job creation and for the formation of social relationships for the elderly.

An Expansion and Application of Human Coexistence Robot System Using Smart Devices

In the context of developing technologies for realizing a user-centric smart society, robot technology is gaining importance for responding to safety issues such as for those living alone and elderly persons. Therefore, in recent years, various robots have been developed to perform social exchanges with people in daily life. We also aim to develop a support system that can be easily used in everyday life through the application of smart device technology that is familiar to people. Therefore, in this paper, we discuss the process of developing robot partners according to various user needs, from the viewpoint of hardware and software development, as human coexistence robot partners. In addition, we show an example of the scalability and application of robot technology using smart devices. First, we describe our smart device-based robot partner system. Next, we describe the development of a robot partner comprising various modules. Finally, we present several examples of robot systems for social implementation and address the applicability of our proposed system.

Who is mentally healthy? Mental health profiles of Japanese social networking service users with a focus on LINE, Facebook, Twitter, and Instagram

Background

Both negative and positive associations between social networking service (SNS) usage and mental health have been suggested by previous studies; however, their differences by type of SNS and age remain unclear. We addressed this issue based on the frequency of traditional communication such as face-to-face and non-face-to-face communication (e.g., phone, email, and letters).

Methods

In total, 8,576 individuals participated, including 2,543 aged 18–39, 3,048 aged 40–64, and 2,985 aged over 65 years. They were asked to indicate their frequency of SNS usage, both for posting and checking, of LINE (a popular message application in Japan), Facebook, Twitter, and Instagram, with frequent usage defined as posting or checking more than a few times a week. To determine mental health status, WHO-5 (i.e., well-being), K6 (i.e., distress symptoms), and feelings of loneliness were assessed. Multiple and logistic regression analyses were adjusted for the frequency of traditional communication. To avoid type 1 error, a Bonferroni correction of p ≤ 0.002 was applied in the regression models (p = 0.05/18, a number of regression models).

Results

The most frequently used SNS across the three age groups was LINE; frequent usage (both posting and checking) among older adults was independently associated with better well-being. Frequent posting on Facebook was associated with better well-being in middle-aged adults. Young adults who frequently checked on Instagram showed a tendency toward better well-being and lower distress symptoms. On the contrary, frequent usage of Twitter was associated with distress symptoms or feelings of loneliness across all three age groups.

Conclusions

We found generational and SNS-type-dependent negative and positive associations between SNS use and mental health, indicating the possible influences of SNS use and the importance of non-SNS communication.

The Smiles of Older People through Recreational Activities: Relationship between Smiles and Joy

Recreational activities are found to increase people's smiles, arising joy in older people, but there is limited research on this topic within the Japanese context. This cross-sectional study aimed to measure the quality and frequency of smiles in older people living in rural settings using a smile analysis application. The participants comprised 13 females aged over 65 years who lived in Unnan City, Japan, and regularly attended recreational meetings. In this study, the recreational activity that the participants joined was a game called Mattoss. A video camera captured the participants' faces, while a smile assessment application assessed their facial expressions for smiles and joy. A total of 2767 smiles were recorded. For validity, we calculated the Spearman's rho score between smile and joy, which was 0.9697 (p < 0.001), while for reliability, we determined the Spearman's rho score for each participant, which exceeded 0.7 (p < 0.001). Surges of smiles were induced by one's own mistakes, successes, and big mistakes in the game and by severe or mild judgments by the referee. High validity and reliability of smile evaluation were demonstrated. The study found that smiling increased during recreational activities. Therefore, recreational activities can be encouraged for older people living in rural communities.

Prospective Study of Engagement in Leisure Activities and All-Cause Mortality Among Older Japanese Adults

Background

Engagement in leisure activities among older people is associated with a lower risk of mortality. However, no studies have been conducted focusing on the difference of associations with mortality risk among multiple types of leisure activities.

Methods

We examined prospectively the association of engagement in leisure activities with all-cause mortality in a cohort of older Japanese adults. The Japan Gerontological Evaluation Study included 48,216 participants aged 65 years or older. During a mean follow-up period of 5.6 years, we observed 5,575 deaths (11.6%). We investigated the total number of leisure activities, as well as combinations of 25 different leisure activities with Cox proportional hazards models, adjusting for potential confounding factors.

Results

We found a linear relationship between the total number of leisure activities and mortality hazard (adjusted hazard ratio, 0.93; 95% CI, 0.92–0.95). Furthermore, engagement in leisure activities involving physical activity, as well as group-based interactions, showed the strongest associations with lowered mortality. By contrast, engagement in cultural leisure activities and solitary leisure activities were not associated with all-cause mortality.

Conclusion

Although we cannot rule out residual confounding, our findings suggest that encouraging engagement in physically-active group-based leisure activities may promote longevity in older adults.

Predictors of older adults' objectively measured social isolation: A systematic review of observational studies

BACKGROUND

Preventing social isolation is essential for promoting healthy aging. This study aims to 1) systematically review and synthesize the predictors of objectively measured social isolation from observational studies that have treated isolation as an outcome in community-dwelling older adults, and 2) overview previous studies in this area and reveal an agenda to develop future research.

METHODS

Peer-reviewed primary studies published in English or Japanese were identified from PubMed, ScienceDirect, PsycINFO, Igaku-Chuo-Zasshi, and CiNii. We followed the PRISMA statement. Risk of bias of included studies was assessed using the Newcastle-Ottawa Scale.

RESULTS

Of the 1,161 studies identified, 10 were included in the review. Most studies were cross-sectional and published in the past 20 years. The risk of bias score ranged from 3 to 6 for the individual studies, indicating a moderate to high risk. The assessment measures for social isolation and proportion of isolated subjects varied greatly across studies. Findings on the predictors of social isolation from each study were clustered into four categories: socio-demographic factors, physical health factors, psychological and cognitive factors, and social and cultural factors.

CONCLUSIONS

It was difficult to confirm these predictors conclusively because of the cross-sectional study design and a huge variety of assessment tools for social isolation. This result suggests the need to build consensus on the appropriate scales and standard cut-off points for assessing social isolation. Furthermore, longitudinal studies are urgently required. When considering predictors of social isolation, it is also essential to consider the regional and ethnic background of the samples studied.

Participation profiles among Chinese stroke survivors: A latent profile analysis

Objectives

To investigate the current status of participation and explore the characteristics of individuals with different levels of participation among stroke survivors in mainland China.

Design

Cross-sectional survey.

Setting

Participants were recruited by convenience sampling from the neurology department of the tertiary hospitals and communities.

Subjects

Stroke survivors (N = 517; mean (±SD) age, 69.97±11.51 y; 36.8% female).

Intervention

Not applicable.

Main outcome measures

Participation was measured using the Chinese version of the Impact on Participation and Autonomy Questionnaire (IPA). Rating of disability was assessed using the Modified Rankin Scale (mRS). The Perceived Social Support Scale (PSSS), the Medical Coping Modes Questionnaire (MCMQ), and the Herth Hope Scale (HHS) were also employed to measure social support, coping strategy, and hope of stroke survivors. The latent profiles analysis (LPA) was conducted using the Mplus version 8.3.

Results

The mean score of participation was 41.21±21.204. Participants were divided into three groups according to the participation using the LPA. The mean score on the sum of IPA for the high, medium, and low participation groups was 18.93±8.529, 42.50±8.302, and 69.44±9.516, respectively.

Conclusions

Stroke survivors have a low level of participation. Stroke survivors with low income, high mRS stage, bad health condition, and being dissatisfied for life tended to have low participation. Healthcare professionals should pay special attention to them and make targeted interventions based on their characteristics.

The values and meanings of social activities for older urban men after retirement

Previous studies have indicated that older men often experience disconnection from the community after retirement. Social activities have been shown to be effective in preventing social isolation among older urban men. Nevertheless, it has been reported that they often do not participate in community social activities and tend to be reluctant to do so. We explored the values and meanings of social activities for retired older men living in an urban area of Japan to understand support using social activities that are more suitable for them. Semi-structured interviews were conducted with 15 older men (aged 68–80 years; M = 74.6 ± 3.79 years) about their interactions with family and non-family members, and their participation in various community social activities. The grounded theory approach was used for the analysis. As a result, the following five categories were derived as the values that participants place on the social activities that they engage in: “health as a resource and reward for social activities,” “feeling I am still useful,” “feeling that something is my responsibility,” “feeling of time well spent,” and “finding interest through interactions.” In addition, the following three categories were extracted as meanings of social activities: “fulfilling social life,” “maintaining stable family relationships,” and “maintaining safety and peace in the community.” When considering the social activities that older urban retired men are interested in and likely to participate in, these five values can be considered indicators. In contrast, to maintain stable family relationships and safety and peace in the community, participants sometimes used strategies to stop or abandon social activities. Therefore, in situations where a peaceful life within a family or neighborhood is threatened, it may be useful to help set aside sufficient time and allow for psychological leeway in advance to incorporate social activities into their lives.

Factors associated with follow-up difficulty in longitudinal studies involving community-dwelling older adults

This study aims to clarify the factors associated with the gradual withdrawal from society in older adults. We defined the stages of follow-up difficulty based on four follow-up surveys on non-respondents of longitudinal mail surveys in community-dwelling older adults to examine the main factors associated with the stages of follow-up difficulty. We conducted a follow-up mail survey (FL1) with respondents of a baseline survey, and three more follow-up surveys with the non-respondents of each previous survey: simplified mail (FL2), postcard (FL3), and home visit surveys (FL4). The respondents of each follow-up survey were defined as a stage of follow-up difficulty; their characteristics concerning social participation and interaction at baseline in each stage were analyzed. The number of respondents in the FL1, FL2, FL3, and FL4 stages and non-respondents (NR) were as follows: 2,361; 462; 234; 84; and 101, respectively. Participation in hobby groups in FL2 and FL3, sports groups in FL4, and neighborhood association and social isolation in NR were significantly associated with the stage of follow-up difficulty. Based on these results, we conclude that the following factors are associated with each stage of follow-up difficulty: 1) a decline in instrumental activities of daily living in the FL2 and FL3 stages, 2) dislike for participating in physical activity such as sports in the FL4 stage, and 3) social isolation, not even belonging to a neighborhood association due to low social interaction in the NR group.

Social Activities and Health-Related Quality of Life in Rural Older Adults in South Korea: A 4-Year Longitudinal Analysis

During later life, inadequate social interactions may be associated with worse quality of life in older adults. Rural older adults are prone to developing unhealthy lifestyles related to social activities, which can lead to a poorer quality of life than that enjoyed by older adults living in urban areas. This study aimed to describe longitudinal changes in social activity participation and health-related quality of life among rural older adults, exploring potential associations with changes to in-person social activity over four years. We used prospective community-based cohort data from the Korean Social Life, Health, and Aging Project (KSHAP) collected between December 2011 and January 2016. The sample included 525 older adults who completed the measure of health-related quality of life. Our results showed a significant change in health-related quality of life according to changes in participation in meeting with friends. Even though an individual's participation in other social activities did not show significant differences in health-related quality of life, our findings imply that in-person social activities may be an important resource to encourage participation in physical activities and to develop other positive outcomes, such as a sense of belonging or satisfaction with later life, among rural older adults.