Loneliness and Social Engagement in Older Adults Based in Lombardy during the COVID-19 Lockdown: The Long-Term Effects of a Course on Social Networking Sites Use

Social isolation, social media use, and poor mental health among older adults, California Health Interview Survey 2019-2020

BACKGROUND

Older adults' engagement on social media may be a resource to reduce loneliness and improve mental health.

PURPOSE

This study aimed to examine loneliness and social media use and its association with severe psychological distress among older adults and whether social media use moderated the association of loneliness on severe psychological distress among older adults.

METHODS

This study is a secondary analysis of the 2019-2020 California Health Interview Survey. The Kessler 6-item Psychological Distress Scale (K6) assessed symptoms of psychological distress, with a K6 score ≥ 13 associated with severe mental illness. Loneliness was measured using a revised Three Item Loneliness Scale (TILS) score. Multiple regression analyses were conducted to examine associations between loneliness and severe psychological distress.

RESULTS

Loneliness, health status, and identification as Asian, remained strong predictors of severe psychological distress among older adults when adjusting for other factors. In bivariate analysis, high-frequent social media users, but did not remain significant when accounting for covariates. Social media use did not moderate the association between loneliness and severe psychological distress.

CONCLUSION

This study underscores the significant impact of loneliness on poor mental health among older adults, emphasizing that while frequent social media use correlates with severe psychological distress, it may not alleviate the association of loneliness on poor mental health, thus highlighting the urgent need to address social isolation and promote genuine social connectedness, particularly among Asian older adults.

Does Including Facebook Training Improve the Effectiveness of Computerized Cognitive Training? A Randomized Controlled Trial

OBJECTIVE

To determine whether implementing a Facebook training program improves the effectiveness of computerized cognitive training (CCT) in older adults.

DESIGN

Randomized, controlled, double single-blind trial with parallel groups.

SETTING

Community centers.

SUBJECTS

Eighty-six adults between 60 and 90 years old.

INTERVENTIONS

Nine face-to-face 60-min sessions of CCT with VIRTRAEL for all participants. The experimental group received an additional 30 min of Facebook training per session.

MAIN MEASURES

Attention (d2 Test of Attention); learning and verbal memory (Hopkins Verbal Learning Test-Revised); working memory (Letter-Number Sequencing test), semantic and abstract reasoning (Similarities and Matrix Reasoning tests); and planning (Key Search test).

RESULTS

There was a significant Group*Time interaction in the Hopkins Verbal Learning Test-Revised-Trial 3, Letter-Number sequencing, and Matrix tests. Between groups, post-hoc analyses showed a difference in Matrix reasoning (p < .001; d  =  0.893) at post-intervention in favor of the experimental group. Significant main effects of time were found in the CCT group between baseline and 3-month follow-up for Concentration (F  =  26.431, p ≤ .001), Letters and Numbers (F  =  30.549, p ≤ .001), Learning (F  =  38.678, p ≤ .001), Similarities (F  =  69.885, p ≤ .001), Matrix (F  =  90.342, p ≤ .001), and Key Search (F  =  7.904, p  =  .006) tests.

CONCLUSIONS

The utilization of CCT with VIRTRAEL, a freely accessible tool with broad applicability, resulted in enhanced attention, verbal learning, working memory, abstract and semantic reasoning, and planning among older adults. These improvements were sustained for at least three months post-training. Additional training in Facebook did not enhance the effectiveness of CCT.

Interventions to Reduce Loneliness in Community-Living Older Adults: a Systematic Review and Meta-analysis

BACKGROUND

The problem of loneliness has garnered increased attention from policymakers, payors, and providers due to higher rates during the pandemic, particularly among seniors. Prior systematic reviews have in general not been able to reach conclusions about effectiveness of interventions.

METHODS

Computerized databases were searched using broad terms such as "loneliness" or "lonely" or "social isolation" or "social support" from Jan 1, 2011 to June 23, 2021. We reference mined existing systematic reviews for additional and older studies. The Social Interventions Research & Evaluation Network database and Google were searched for gray literature on Feb 4, 2022. Eligible studies were RCTs and observational studies of interventions to reduce loneliness in community-living adults that used a validated loneliness scale; studies from low- or middle-income countries were excluded, and studies were excluded if restricted to populations where all persons had the same disease (such as loneliness in persons with dementia).

RESULTS

A total of 5971 titles were reviewed and 60 studies were included in the analysis, 36 RCTs and 24 observational studies. Eleven RCTs and 5 observational studies provided moderate certainty evidence that group-based treatment was associated with reduced loneliness (standardized mean difference for RCTs =  - 0.27, 95% CI - 0.48, - 0.08). Five RCTs and 5 observational studies provided moderate certainty evidence that internet training was associated with reduced loneliness (standardized mean difference for RCTs =  - 0.22, 95% CI - 0.30, - 0.14). Low certainty evidence suggested that group exercises may be associated with very small reductions in loneliness. Evidence was insufficient to reach conclusions about group-based activities, individual in-person interactions, internet-delivered interventions, and telephone-delivered interventions.

DISCUSSION

Low-to-moderate certainty evidence exists that group-based treatments, internet training, and possibly group exercises are associated with modest reductions in loneliness in community-living older adults. These findings can inform the design of supplemental benefits and the implementation of evidence-based interventions to address loneliness.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO ( CRD42021272305 ).

COVID-19 Imposed Closure of Rural Co-Housing and Loneliness in Older Adults Living Alone: Longitudinal Evidence From South Korea

This study aimed to examine the impact of COVID-19 on loneliness among rural older women in senior cohousing in Korea. Using a natural experimental study design, we investigated how the pandemic-induced closure of cohousing affected the former residents' loneliness. The sample comprised 84 cohousing residents and 51 individuals in conventional homes. The dependent variable is loneliness, and the independent variables include housing transition, social contact, and support from neighbors and friends. Our findings from fixed effect regression models showed former cohousing residents were less likely to experience loneliness when they had more contact with their friends and neighbors, while negative relationships exacerbated feelings of loneliness. Sharing meals and participating in activities with friends and neighbors in cohousing helped the residents develop effective coping strategies. Senior cohousing in rural areas has the potential to strengthen social ties and protect the most vulnerable subgroup of older adults from social isolation and loneliness.

Perceived dilemma between protective measures and social isolation in nursing homes during the COVID-19 pandemic: a mixed methods study among Swiss nursing home directors

Background

Coronavirus pandemic (COVID-19) particularly affected older adults, with the highest risks for nursing home residents. Stringent governmental protective measures for nursing homes unintendedly led to social isolation of residents. Nursing home directors (NDs) found themselves in a dilemma between implementing protective measures and preventing the social isolation of nursing home residents.

Objectives

The objectives of this study were to describe protective measures implemented, to investigate NDs' perception of social isolation and its burden for nursing home residents due to these measures, and to explore experiences of NDs in the context of the dilemma.

Methods

Cross-sectional embedded mixed-method study carried out by an online survey between April 27 and June 09, 2022, among NDs in the German-speaking part of Switzerland. The survey consisted of 84 closed-ended and nine open-ended questions. Quantitative findings were analyzed with descriptive statistics and qualitative data were evaluated using content analysis.

Results

The survey was completed by 398 NDs (62.8% female, mean age 55 [48-58] years) out of 1'044 NDs invited.NDs were highly aware of the dilemma. The measures perceived as the most troublesome were restrictions to leave rooms, wards or the home, restrictions for visitors, and reduced group activities. NDs and their teams developed a variety of strategies to cope with the dilemma, but were burdened themselves by the dilemma.

Conclusion

As NDs were burdened themselves by the responsibility of how to deal best with the dilemma between protective measures and social isolation, supportive strategies for NDs are needed.

The relationship between social media use and psychosocial outcomes in older adults: A systematic review

OBJECTIVES

Social isolation and loneliness are prevalent in older adults and are detrimental to physical and mental health. Social media use has been shown to be effective in maintaining social connections and improving older adults' psychosocial outcomes. This study aimed to systematically review and synthesize current research on this topic.

DESIGN

Searches were conducted in November 2021 (and updated in October 2023) in PsycINFO, PubMed, and CINAHL. Inclusion criteria: (1) participants ≥ 65 years (mean, median, or minimum age) and (2) reported impact of social media use on psychosocial outcomes (including loneliness, depression, anxiety, social connectedness, wellbeing, life satisfaction, and quality of life). Quality appraisal tools were utilized, and results were synthesized using narrative synthesis.

RESULTS

Sixty-four papers met inclusion criteria, including cross-sectional (n = 38), observational longitudinal (n = 6), interventional (n = 9), mixed-methods (n = 4), and qualitative (n = 7) studies. Participant numbers ranged from 6 to 16,925. While associations between social media use and positive psychosocial outcomes were generally reported in cross-sectional studies, the impact of social media use over time from longitudinal studies was mixed and inconclusive.

CONCLUSIONS

While social media use is associated with positive psychosocial outcomes, casual conclusions cannot be drawn. Few longitudinal and randomized controlled trial studies existed, and these reported mixed findings. Large variations in study methodology including participants, measurement of social media use, and outcome measures contributed to the inconsistencies of findings. Addressing this heterogeneity through standardized approaches and more rigorous research may enhance understanding.

What works in interventions targeting loneliness: a systematic review of intervention characteristics

BACKGROUND

Loneliness has been linked to negative health and economic outcomes across the life course. Health effects span both physical and mental health outcomes, including negative health behaviours, lower well-being, and increased mortality. Loneliness is however preventable with effective intervention. This systematic review aims to identify what has worked in interventions for loneliness to guide the development of future interventions.

METHODS

Eight electronic databases (Medline, Embase, PsycINFO, Social Policy and Practice, Social Sciences Citation Index, Epistemonikos, CINAHL, Cochrane Library) were systematically searched from inception to February 2022 using terms for intervention and loneliness to identify relevant interventions in the general population. No restrictions on age, socio-economic status, or geographic location were imposed. Studies were to measure loneliness as the primary outcome through a validated scale or single-item question. Case studies were excluded. Additional studies were identified through citation chasing. Extracted data included study and intervention characteristics, and intervention effectiveness for cross-study comparison. Critical appraisal was conducted using the Joanna Briggs Institute and Critical Appraisal Skills Programme tools before the studies were summarised in a narrative synthesis.

RESULTS

Searches identified 4,734 hits, from which 22 studies were included in this review. Of these studies, 14 were effective in reducing loneliness. Additionally, five studies presented unclear findings, and three concluded no decrease in loneliness. Interventions varied between group vs. individual format, online vs. in person delivery, and regarding both intervention duration and individual session length. Furthermore, this review highlighted five key areas when considering designing an intervention for loneliness: use of between session interaction, inclusion of clear learning mechanisms, role of active participation, number of opportunities for group or facilitator interaction, and variation in teaching and learning styles.

CONCLUSIONS

Group sessions seem preferred to individual formats, and interaction through active participation and group or facilitator contact appear beneficial, however studies also recognised the importance of a person-tailored approach to delivery. Studies suggest there is no 'quick fix' to loneliness, but that learnt practices, behaviours, and community connection should be built into one's lifestyle to achieve sustained intervention effectiveness. Future interventions should consider longer follow-up periods, male and populations with lower educational levels.

Investigating and promoting health behaviors reactivity among Hong Kong older adults in the post-COVID-19 Era: An exploratory network analysis

BACKGROUND

Physical distance has increased the risk of developing a variety of health problems, especially among older people. During the COVID-19 lockdown period, physical activity decreased, screen time increased, food consumption increased, as well as exposure to unhealthy behaviour, leading to poorer sleep quality and more negative emotions, which ultimately led to poorer physical health, mental health, and subjective vitality among older adults. Although there were numerous research studies on changes in health behaviours during COVID-19, only a few were targeted at older adults, and none were conducted in Asian countries.

METHOD

The current study is aiming to identify the changes in health behaviours, as well as their associations with older adults' mental health as a result of the COVID-19 pandemic among Hong Kong older adults, using exploratory network analysis. In this study, a random tele-survey was conducted among older adults.

RESULTS

A total of 664 participants have been involved in the telephone survey, with 213 males and 451 females, of which mean age was 74.37. The explored network showed strong centrality and edge stability, thus enabling to reveal an overview of the associations between health behaviours and mental well-being of older adults. The lavaan model has also demonstrated the casual paths within the explored network, which indicated the significant impact of sleeping quality, eating habits and social networking on resilience.

CONCLUSION

The outcomes of the study were able to identify the lifestyle changes of Hong Kong older adults due to COVID-19. Although the present study is not regarded as novel internationally, it may be representative of the Hong Kong community. In order to facilitate active aging during the pandemic, a user-friendly electronic platform for healthy living should include older adults in the future.

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

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

Sustainable Smart Cities-Social Media Platforms and Their Role in Community Neighborhood Resilience-A Systematic Review

The COVID-19 pandemic took most communities off guard and has highlighted gaps in community preparedness and resilience in spite of the numerous technological advancements and the variety of available social media platforms that many relied on during lockdown periods. This served to emphasise the necessity for exploring the roles of social media and smart city technologies in mitigating pandemic impacts. In this systematic literature review, we examined twelve articles on social media usage and smart city technologies and their contributions to community resilience during COVID-19. The analysis focused on the use of social media platforms and smart city technologies during and after lockdown periods, examining their role in fostering community resilience. Results indicate that social media and smart city technologies were instrumental in helping communities adapt and recover from the pandemic. While past studies have examined community resilience, social media, or smart cities separately, there is limited literature collating insights on the three elements combined. We therefore argue that these technologies, employed collaboratively, enhance community resilience during crises. Nevertheless, further research is recommended, particularly on urban resilience and comparative analyses to deepen our understanding of the complex interplay between these variables.

Mobile phone use before and during the COVID-19 pandemic – a panel study of older adults in seven countries

The aim of this study was to investigate the changes in older adults’ mobile phone use from before to during the COVID-19 pandemic. The media displacement and digital divide approaches served as the theoretical frameworks of the study. The data were drawn from the 2018 and 2020 waves of the Aging + Communication + Technology cross-national longitudinal panel study. The sample consisted of older Internet users, aged 62 to 96 (in 2018), from Austria, Canada, Finland, Israel, the Netherlands, Romania, and Spain, who participated in both waves (N = 4,398). Latent class analysis and latent transition analysis with multinomial regression models were the main methods applied to the data. With regard to the findings, three mobile phone function use profiles—Narrow Use, Medium Use, and Broad Use—were identified from the data. Lower age, being married, higher income, and place of residence (in 2018) predicted belonging to the three profiles, while country differences in the prevalence of the profiles were substantial. Between 2018 and 2020, transition from one profile to another was relatively rare but typically toward the “Broad Use” category. Profile transitions were most common in Romania, while stability was highest in Finland, Israel, and Canada. In addition, gender, age, marital status, and place of residence predicted the likelihood of changing from one profile to another between 2018 and 2020. The results suggest that older adults’ mobile phone function use is relatively stable over a two-year time span. While new mobile phone functions are adopted, they seem to augment the spectrum of mobile usage rather than displace older similar functionalities. In addition, demographic, socioeconomic, and country-level digital divides, although slightly modified over time, remain significant among older adults.

Social connections and participation among people with mild cognitive impairment: barriers and recommendations

Objective

Social connections and participation are essential for individuals with mild cognitive impairment (MCI) to prevent the progression of cognitive decline and enhance their overall well-being. However, existing research has primarily focused on environmental barriers, overlooking personal factors and the interconnected nature of these barriers. Moreover, there is a lack of understanding regarding social connections and participation challenges specific to people with MCI in low- and middle-income countries. Therefore, this study aimed to explore the barriers that hinder social connections and participation among people with MCI in China and investigate opportunities to design appropriate supportive interventions.

Methods

Thirty-one people with MCI (13 males and 18 females; mean age = 82.74 years, SD = 7.69; mean MoCA score = 21.26, SD = 2.44) and 13 caregivers were recruited to attend focus groups. In addition, 10 therapists were interviewed using a semi-structured interview guide. Focus groups and interviews were audio-recorded, transcribed, and analyzed using a framework analysis approach.

Results

We found that the ability to build social connections among people with MCI is affected by mobility challenges, intensive grandparenting responsibilities, availability of suitable activities, and feelings of exclusion in a closed-minded community environment. Personal reasons, such as lower social efficacy, inability to find suitable social activities, and intensive family responsibilities, discourage people with MCI from social participation. The digital literacy of people with MCI depends on their motivation to learn and use digital tools; people with MCI who live in a community have a higher digital literacy than those living in care centers. The motivation to achieve digital literacy is affected by perceived benefits, costs of technology use, and social influence.

Conclusion

Multidimensional initiatives are needed to address barriers to social connections, participation, and technology adoption among individuals with MCI. This includes organizing and engaging in social activities, promoting awareness and education on the importance of social participation, and exploring technology-based interventions to improve memory and storytelling abilities. These efforts can create a supportive environment and empower individuals with MCI to participate actively in social interactions, enhancing their overall well-being.

How Social Connection and Engagement Relate to Functional Limitations and Depressive Symptoms Outcomes After Stroke

BACKGROUND

Stroke commonly leads to disability and depression. Social connection and engagement can be protective against functional decline and depression in the general population. We investigated the effects of social connection and engagement on trajectories of function and depressive symptoms in stroke.

METHODS

This is a longitudinal study, which included 898 participants with incident stroke from the HRS study (Health and Retirement Study) between 1998 and 2012. Multilevel modeling was used to examine associations of social connection and engagement with changes in functional limitations in instrumental activities of daily living (IADLs) and depressive symptoms over time. Models controlled for age, gender, education, and race/ethnicity. Moderation analyses examined whether high social connection and engagement reduced depressive symptoms for survivors with high IADL impairment.

RESULTS

Social connection and engagement were generally associated with fewer IADL limitations and depressive symptoms at the time of stroke and after stroke. For example, participants who felt lonely and did not provide help to others before stroke had more IADL limitations. Prestroke volunteering was associated with less increase in IADL limitations with stroke and increase in having friends and providing help to others compared with one's prestroke status were associated with fewer IADL limitations after stroke. For depressive symptoms, participants who felt lonely and did not have a friend or partner before stroke had more depressive symptoms, and participants who had children residing nearby before stroke showed less increase in depressive symptoms. Moderation effects were not found for social connection and engagement on high IADL impairment and depressive symptoms.

CONCLUSIONS

Findings suggest that social connection and engagement may reduce the negative physical and psychological outcomes of stroke, both at baseline and after stroke. Efforts to enhance social engagement and diminish loneliness may both enhance population well-being and enhance resilience and recovery from stroke and other illnesses.

Fear of COVID-19 and Adverse Psychological Health Outcomes Among Chinese Elderly: a Serial Mediation Model of Social Participation and Loneliness

This cross-sectional study examined fear of COVID-19, social participation, loneliness, and adverse psychological health outcomes among Chinese older adults after the pandemic control measures were relaxed. We also tested the correlations among these variables and examined the serial-mediating effects of social participation and loneliness on the relationship between fear of COVID-19 and adverse psychological health outcomes. Participants were 508 Chinese elderly individuals (Mage = 70.53 ± 7.90 years; 56.5% women). We used Pearson correlation analyses and Hayes' PROCESS macro analysis (Model 6). Respondents had a relatively higher level of fear of COVID-19 compared to the general population. Their levels of loneliness, anxiety, and depression were higher than those of Chinese older adults who were surveyed before the restriction policy changed in previous research. The correlations among fear of COVID-19, social participation, loneliness, and adverse psychological health outcomes were significant, supporting the serial-mediating effects of social participation and loneliness on the relationship between fear of COVID-19 and adverse psychological health outcomes. Attention should be paid to the mental health issues of Chinese older adults, and the impacts of fear of COVID-19 and social participation on their mental health should be emphasized. Future researchers should use random systematic sampling methods, conduct longitudinal tracking and perform intervention studies.

Age, Loneliness, and Social Media Use in Adults during COVID-19: A Latent Profile Analysis

Loneliness has been linked to morbidity and mortality across the lifespan. Social media could reduce loneliness, though research on the relation between social media and loneliness has been inconclusive. This study used person-centered analyses to elucidate the inconsistencies in the literature and examine the possible role technology barriers played in the relation between social media use and loneliness during the COVID-19 pandemic. Participants (n = 929; M age = 57.58 ± 17.33) responded to a series of online questions covering demographics, loneliness, technology barriers, and social media use (e.g., Facebook, Twitter, etc.) across a range of devices (e.g., computer, smartphone, etc.). A latent profile analysis was conducted to identify distinct profiles of social media use, loneliness patterns, and age. Results yielded five distinct profiles characterized that showed no systematic associations among age, social media use, and loneliness. Demographic characteristics and technology barriers also differed between profiles and were associated with loneliness. In conclusion, person-centered analyses demonstrated distinct groups of older and younger adults that differed on social media use and loneliness and may offer more fruitful insights over variable-centered approaches (e.g., regression/correlation). Technology barriers may be a viable target for reducing loneliness in adults.

Ageing and Loneliness in Times of Pandemic: A Scoping Review

Society is immersed in a process of demographic transformation of great relevance: the ageing of the population. During the ageing stage, relevant changes occur, such as age-related losses, lack of formal and informal support or changes in social roles, which can cause situations of isolation or loneliness in older people. After the Spanish government decreed a state of alarm throughout the national territory in response to the arrival of SARS-CoV2, the confinement of the entire population was established, and only essential services and authorized persons could continue to carry out their daily activities and professional tasks. In addition, since the beginning of the pandemic, older people were considered high-risk people, a circumstance that increased their isolation situation.

OBJECTIVE

Understand, organize and systematically analyse the scientific evidence generated in relation to the impact that the COVID-19 pandemic has had on the processes and feelings of isolation and loneliness of the elderly population, from the beginning of the health crisis until the date of search.

MATERIALS AND METHODS

a scoping review was conducted using the methodology of Arksey and O'Malley, which included a review of the studies available in the online databases Proquest, Scopus and WOS. From the search, information related to the isolation and collective of elderly people during the pandemic was extracted.

RESULTS

a total of 32 articles were included, from which three fundamental areas of analysis emerged and three issues emerged: older people and institutionalisation during the pandemic, ageism and hospitalisation of the elderly during the pandemic, and loneliness and isolation of older people throughout the pandemic.

DISCUSSION

the lack of material resources and infrastructures to be able to face the problem of isolation in institutions was evident. The importance of acquiring, on the part of the elderly, competences, knowledge and skills in new technologies in order to continue with contact with their peer group and family was also observed.

CONCLUSIONS

this study identifies areas already understood, as well as knowledge gaps, that allow for determining opportunities for future research and thus the ability to improve in situations similar to the one that occurred.

COVID-19 in Mass Media: Manufacturing Mass Perceptions of the Virus among Older Adults

According to the latest The Global Risks Report (2022) of World Economic Forum, the large-scale coronavirus disease 2019 (COVID-19) threat creates various tensions that might lead to unexpected cascading impacts in various domains. Nevertheless, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, about 120 nm in diameter, remains invisible to people whose cognition, emotions, and health-related behaviors are driven primarily by the subjective perception of the virus. Mass media communicating information, symbols, beliefs, and codes of conduct to the population contribute widely to the socially constructed representations of the new SARS-CoV-2 virus. Thus, the aim of the current research is to investigate the impacts of the common COVID-19 mass media image of the “ball with spikes” representing the SARS-CoV-2 virus on older adults particularly vulnerable to the COVID-19 coronavirus disease and fake news dissemination. This research is based on an innovative mixed-methods research design that combines questionnaires (N = 144), semi-structured research interviews, and pictographic measures (N = 26). The primary results demonstrate that individuals’ perceptions of and emotional reactions to the invisible SARS-CoV-2 virus are shaped by mass media exposure, as the “ball with spikes” became a familiar symbol of the COVID-19 virus, marked by the symbolism of dangerousness and mystery with a divisive aesthetic. The current research that aims to highlight the role of mass media as the vector of an icon image of the new SARS-CoV-2 virus provides additional elements that may contribute to improved crisis management effectiveness of future pandemic outbreaks.

Changes in Internet use patterns among older adults in England from before to after the outbreak of the COVID-19 pandemic

The COVID-19 pandemic brought about an increased reliance on the Internet for various daily activities. Given the known digital divide, it is important to understand whether older adults changed their Internet use patterns, but current evidence is limited to cross-sectional studies. This study documents changes in frequency and types of Internet use among older adults from before to shortly after the outbreak of the COVID-19 pandemic (2018/2019 to June/July 2020), and the factors predicting regular use during these early days of the pandemic. Using data on 6,840 adults aged 50 + from the nationally representative English Longitudinal Study of Ageing, we apply longitudinal fixed-effects models to examine within-individual changes in Internet use behaviour. There was no change in the likelihood of daily Internet use between 2018/2019 and June/July 2020, despite the increased digitalisation of services over the pandemic. Daily use in June/July 2020 was negatively related to age, neighbourhood deprivation, and loneliness, and positively related to partnership status, education, employment, income, and organisation membership. Using the Internet for making calls and getting information about Government services increased, which was important given the social restrictions and overall uncertainty. However, Internet use for finding health-related information decreased. As the world moves towards digital alternatives post-pandemic, it is important to continually ensure older adults are not at risk of exclusion.

"How Social Connection and Engagement Relate to Functional Limitations and Depressive Symptoms Outcomes After Stroke"

Background

Stroke commonly leads to disability and depression. Social connection and engagement can be protective against functional decline and depression in the general population. We investigated the effects of social connection and engagement on trajectories of function and depressive symptoms in stroke.

Methods

Participants were 898 individuals with incident stroke from the Health and Retirement Study between 1998-2012. Multilevel modeling was used to examine associations of social connection and engagement with changes in functional limitations in instrumental activities of daily living (IADLs) and depressive symptoms over time. Models controlled for age, gender, education, and race/ethnicity. Moderation analyses examined whether high social connection and engagement reduced depressive symptoms for survivors with high IADL impairment.

Results

Social connection and engagement were generally associated with fewer IADL limitations and depressive symptoms at the time of stroke and after stroke. For example, participants who felt lonely and did not provide help to others before stroke had more IADL limitations. Pre-stroke volunteering was associated with less increase in IADL limitations with stroke and increase in having friends and providing help to others compared to one's pre-stroke status were associated with fewer IADL limitations after stroke. For depressive symptoms, participants who felt lonely and did not have a friend or partner before stroke had more depressive symptoms, and participants who had children residing nearby before stroke showed less increase in depressive symptoms. Moderation effects were not found for social connection and engagement on high IADL impairment and depressive symptoms.

Conclusions

Findings suggest that social connection and engagement may reduce the negative physical and psychological outcomes of stroke, both at baseline and after stroke. Efforts to enhance social engagement and diminish loneliness may both enhance population well-being and enhance resilience and recovery from stroke and other illnesses.

A Systematic Literature Review of Loneliness in Community Dwelling Older Adults

Research on loneliness is extensive. This paper presents a systematic review of intervention studies, outlining the antecedents to, and consequences of loneliness in community-dwelling older people. Using PRISMA methodology, a systematic literature review was conducted between January and August 2021 resulting in 49 useable articles. Papers were included if they: (a) investigated older people (+50); (b) were living in community dwellings; (c) had been published in English; (d) had titles or abstracts available and, (e) were published between 2016 and 2021. This study found the antecedents and consequences of social, emotional and existential loneliness differ, however, the vast majority of research has not examined the unique types of loneliness and instead kept loneliness as a generic term, despite the acceptance that various types of loneliness exist. In addition, the findings of intervention studies identified through this review have yielded mixed results. Those interventions focused on improving personal and psycho-social resources for older people fared better outcomes than those focused on technological and social connections alone. This paper reports important implications for the future of research conducted on loneliness and interventions accordingly.

Digital Engagement of Older Adults: Scoping Review

BACKGROUND

Digital technologies facilitate everyday life, social connectedness, aging at home, well-being, and dignified care. However, older adults are disproportionately excluded from these benefits. Equal digital opportunities, access, and meaningful engagement require an understanding of older adults' experience across different stages of the technological engagement life cycle from nonuse and initial adoption to sustained use, factors influencing their decisions, and how the experience changes over time.

OBJECTIVE

Our objectives were to identify the extent and breadth of existing literature on older adults' perspective on digital engagement and summarize the barriers to and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement.

METHODS

We used the Arksey and O'Malley framework for the scoping review process. We searched MEDLINE, PsycINFO, CINAHL, Web of Science, and ACM digital library for primary studies published between 2005 and 2021. The inclusion and exclusion criteria were developed based on the Joanna Briggs Institute (participants, content, and context) framework. Studies that investigated the digital engagement experience as well as barriers to and facilitators of older adults' digital technology engagement were included. The characteristics of the study, types of digital technology, and digital engagement levels were analyzed descriptively. Content analysis was used to generate tentative elements using a congruent theme, and barriers and facilitators were mapped over the capability, opportunity, and motivation behavior change model (COM-B) and the theoretical domain framework. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews).

RESULTS

In total, 96 publications were eligible for the final charting and synthesis. Most of the studies were published over the past 5 years, investigated the initial adoption stage of digital engagement, and focused on everyday technologies. The most cited barriers and facilitators across the engagement stages from each COM-B component were capability (eg, physical and psychological changes and lack of skill), opportunity (eg, technological features, environmental context, and resources), and motivation (eg, optimism from perceived usefulness and beliefs about capability).

CONCLUSIONS

The COM-B model and theoretical domain framework provide a guide for identifying multiple and intertwined barriers and facilitators at each stage of digital engagement. There are limited studies looking into the whole spectrum of older adults' digital technology experience; in particular, studies on technological nonuse and sustained use stages are rare. Future research and practice should focus on tailored interventions accounting for the barriers to older adults' digital engagement and addressing capabilities, motivation, and opportunities; affordable, usable, and useful digital technologies, which address the changes and capability requirements of older adults and are cocreated with a value framework; and lifelong learning and empowerment to develop older adults' knowledge and skills to cope with digital technology development.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/25616.

Changes in life satisfaction, depression, general health and sleep quality of Spanish older women during COVID-19 lockdown and their relationship with lifestyle: an observational follow-up study

OBJETIVES

To analyse the effects of COVID-19 lockdown on mental well-being variables of older women, and to determine the influence of lifestyle and age on such effects. The hypothesis of the study was that all parameters related to mental well-being would worsen in older women during the COVID-19 lockdown.

DESIGN

Observational follow-up study. Pre lockdown measurements were taken before the lockdown. Post lockdown measurements were taken as soon as began the de-escalation.

SETTING

Senior centres in the Region of Murcia (Spain).

PARTICIPANTS

The sample was composed of 40 older women volunteers, over 54 years of age (mean age=62.35±8.15 years).

PRIMARY AND SECONDARY OUTCOME MEASURES

Pre lockdown and post lockdown evaluations were carried out face to face. The following questionnaires were completed: Satisfaction with Life Scale, The Center for Epidemiologic Studies Depression Scale, The Short Form 36 Health Survey, The Pittsburgh Sleep Quality Index, the Global Physical Activity Questionnaire and Prevention with Mediterranean Diet.

RESULTS

Post lockdown, a worsening was found in the variables of life satisfaction (p=0.001); depression (p<0.001), quality of life in physical role (p=0.006), pain (p=0.004), emotional role (p<0.001) and mental health (p<0.001); and sleep quality (p=0.018), sleep latency (p=0.004), sleep disturbances (p=0.002) and global sleep quality score (p=0.002). It was found how age influenced the variables of pain (p=0.003) and social role (p=0.047), as well as the influence of a healthy lifestyle on the variables analysed (F=6.214; p=0.017). Adherence to the Mediterranean diet was shown to be a protective factor against increased depression (p=0.03). Spending time sitting was shown to be a risk factor for physical role health (p=0.002), as was advanced age on health due to worsening pain (p=0.005), or an unhealthy lifestyle on increased consumption of sleeping aids (p=0.017).

CONCLUSION

The lockdown had a great negative impact on Spanish older women on mental well-being variables.

TRIAL REGISTRATION NUMBER

NCT04958499.

Visiting parents in times of COVID-19: The impact of parent-adult child contacts on the psychological health of the elderly

Using the 8th wave of the SHARE and the SHARE Corona Survey, we investigated whether the disruption of parent-adult child contacts due to social distancing restrictions increased the symptoms of depression among old age individuals during the first wave of the COVID-19 pandemic. We model the relationship between the disruption of parent-adult child contacts and the mental health of the elderly using a recursive simultaneous equation model for binary variables. Our findings show that the likelihood of disruption of parent-adult child contacts was higher with adult children who do not live with or close to their parents (i.e., in the same household or in the same building) for whom contact disruption increases about 15 %. The duration of restrictions to movement and lockdowns also has a positive and significant effect on parent-child contact disruption: an additional week of lockdown significantly increases the probability of parent-child contact disruption, by about 1.5 %. The interventions deemed essential to reduce the spread of the pandemic, such as the "stay-at-home" order, necessarily disrupted personal parent-child contacts and the social processes that facilitate psychological well-being, increasing the probability of suffering from a deepening depressed mood by about 17 % for elderly parents.

The Psychological Well-Being of Older Chinese Immigrants in Canada amidst COVID-19: The Role of Loneliness, Social Support, and Acculturation

This study examined the effects of loneliness, social support, and acculturation on psychological well-being, as indexed by general emotional well-being and life satisfaction, of older Chinese adults living in Canada during the COVID-19 pandemic. A total of 168 older Chinese adults, recruited via WeChat and the internet, completed an online study through a facilitated Zoom or phone meeting, or through a website link, individually or in a group. The testing package included demographic information, The UCLA Loneliness Scale, The Multidimensional Perceived Social Support Scale, Vancouver Index of Acculturation, The Satisfaction with Life Scale, and The World Health Organization’s Five Well-Being Index. The results showed that the psychological well-being (both general emotional well-being and cognitively perceived life satisfaction) was positively predicted by perceived social support but negatively predicted by loneliness. Acculturation was not predictive of both outcomes, and it did not moderate the predictive relationships of social support or loneliness. The results shed light on the importance of community services that target enhancing social support and reducing loneliness in promoting psychological well-being of older Chinese immigrants in Canada amidst and post the pandemic.

Social networking site usage: A systematic review of its relationship with social isolation, loneliness, and depression among older adults

OBJECTIVE

Older adults, age ≥ 60 years, are at risk of depression, which is aggravated by loneliness and social isolation. The use of social networking sites (SNS) has been reported to be beneficial to help people stay in touch with their families and communities. The purpose of this study was to examine the relationship between SNS usage and social isolation, loneliness, and depression among older adults.

METHODS

The online electronic search for literature was conducted up to June 2020 using three databases and searching from reference lists to find potential studies. The inclusion criteria were based on three main study characteristics: (i) a study population of adults age ≥ 60 years, (ii) examine SNS usage, and (iii) report depression or loneliness or social isolation as outcomes.

RESULTS

Fifteen articles were included: ten observational and five experimental studies. Five studies focused on depression and five studies on loneliness/social isolation, while five studies reported on both outcomes. Among observational studies, there was some evidence that SNS usage was associated with lower levels of depression and loneliness scores, but a very limited number of experimental studies were able to obtain similar results. For social isolation, no study found significant associations between SNS usage and lower levels of social isolation.

CONCLUSIONS

This review found very limited evidence, especially from experimental studies, to support associations between SNS use with depression, loneliness, and social isolation among older adults. More studies are needed to enhance understanding to make valid conclusions.

The systematic review was registered in the PROSPERO database on 10 April 2019 and updated in July 2020 (CRD42019125267).

Use of Digital Tools, Social Isolation, and Lockdown in People 80 Years and Older Living at Home

The COVID-19 crisis and associated lockdowns have exposed the extent of social isolation among older adults (OAs). Currently, the French government and medical, social, and charitable organizations are working to find means of limiting the multiple psychological and physical consequences of social isolation on the health of OAs. One proposal is to help the elderly become more comfortable using digital tools (DTs). However, the ability of DTs to reduce social isolation is disputed in the literature. This study aimed to collect the views of OAs on social isolation; to identify the determinants of the use or not of DTs, in particular in the context of a lockdown; and the role of DTs in the strategy to reduce social isolation. This qualitative study was based on 27 semi-structured individual interviews with OAs ≥ 80 years, in Côte-d’Or and Haute-Marne (French departments), from March to May 2021. A total of 96.3% of participants had already owned one or more DTs (mobile phone, tablet, or computer) for several years. The lockdown had not prompted the population to equip themselves more. The most common reason for using DTs was to maintain contact with relatives, and 63% of the participants said that DTs have a positive impact in reducing social isolation. However, there is a significant need for assistance and training in their use, especially since many services are now offered online. The participants suggested that the key to minimizing social isolation remained the maintenance of social contacts. In conclusion, DTs appear to be useful for helping the elderly maintain social links with relatives and, therefore, have a strategic place in the reduction of social isolation. However, these tools should not replace in-person interactions.

Impact of Coronavirus Disease 2019 on Geriatric Psychiatry

On March 11, 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, a global pandemic. This pandemic disrupted health care for patients and providers. Uncertainty about COVID-19 played a significant role in the negative mental health impact in older adults. The effect of increasing age on morbidity and mortality in those who came down with COVID-19 has been substantial. The pandemic took a tremendous toll on the mental and physical health of older adults in general with even more severe consequences in more disadvantaged populations within the group.

Loneliness and functional limitations among older adults with diabetes: Comparing directional models

OBJECTIVE

Middle-aged and older adults with diabetes are at increased risk for loneliness and functional limitations. Cross-sectional and longitudinal associations between loneliness and functional limitations have been demonstrated among the general population, but have not been established among those with diabetes. The purpose of this study was to directly compare the following models describing the direction of the association between loneliness and functional limitations among people with diabetes: (1) loneliness leads to functional limitations, (2) functional limitations lead to loneliness, and (3) a bidirectional association between loneliness and functional limitations.

METHODS

Data came from the Health and Retirement Study. Participants were middle-aged and older individuals with diabetes in the United States (n = 2934). Loneliness and functional limitations were measured at baseline, 4-year follow-up, and 8-year follow-up. Path models for each of the three models, as well as a stability model, were created. Model fit was compared using Akaike's Information Criteria (AIC).

RESULTS

Participants were 54.6% female, 74.98% White, had a mean age of 69.66 years, had an average of 1.48 comorbid chronic conditions, and had diabetes for an average of 10.40 years. The bidirectional model best fit the data as evidenced by the lowest AIC value (AIC = 171,162.81). ∆AIC between the bidirectional model and the next best fitting model was 16.19, indicating strong support for selecting the bidirectional model. Higher levels of loneliness were associated with subsequent higher levels of functional limitations at some time points (βs = 0.07, 0.02) and higher levels of functional limitations were associated with subsequent higher levels of loneliness (βs = 0.13, 0.06) at all time points.

CONCLUSION

Results suggest that the association between loneliness and functional limitations among individuals with diabetes is bidirectional. This study demonstrates the value of directly comparing directional models.

Personal Social Networks of Community-Dwelling Oldest Old During the Covid-19 Pandemic-A Qualitative Study

The COVID-19 pandemic and its related restrictions have affected the everyday life of older people. Advanced age is a significant predisposing factor for a more severe COVID-19 infection, increasing the risk for hospitalization and mortality. Even though restrictions have been, thus, well-grounded, they may also have had detrimental effects on the social well-being of older people. Personal networks and social activity are known protective factors against the premature decline in health and functioning, and it is widely acknowledged that social isolation increases feelings of loneliness, poor quality of life, and even the risk for diseases and disabilities among older adults. This qualitative study investigated changes in personal networks among community-dwelling oldest-old individuals (persons aged 80 and over) during the first and second waves of the COVID-19 pandemic in Finland. The data is part of the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE85+) study, which is an ongoing large longitudinal population-based study in Finland. In this qualitative sub-study, we analyzed fifteen in-depth telephone interviews using directed content analyses and identified five types of changes in personal social networks during the pandemic. In type 1, all social contacts were significantly reduced due to official recommendations and fear of the virus. Type 2 included modified ways of being socially active i.e., by deploying new technology, and in type 3, social contacts increased during the lockdown. In type 4, personal social networks were changed unexpectedly or dramatically due to a death of a spouse, for example. In type 5, we observed stable social networks, which had not been affected by the pandemic. At an individual level, one person could have had different types of changes during the pandemic. These results highlight the heterogeneity of the oldest olds' personal social networks and changes related to them during the exceptional times of the COVID-19 pandemic. Social activity and personal networks play an important role in the well-being of the oldest old, but individual situations, needs, and preferences toward personal social networks should be taken into account when planning social activities, policies, and interventions.

Strategies and actions to enable meaningful family connections in nursing homes during the COVID-19: A Scoping Review

OBJECTIVES

To better understand the impact of visitor restrictions on nursing home residents and their families as well as strategies and actions that were conducted in nursing homes during the COVID-19 pandemic.

METHODS

A scoping review was carried out in October 2020. Several electronic databases were used: Cochrane Plus, Scopus, Web of Sciences and PubMed. 725 results were identified. We included 10 articles.

RESULTS

Thematic analysis obtained the following categories: the impact of COVID-19 on nursing home residents' lives and their families, procedures and frameworks of nursing homes during and after lockdown, and solutions and resources implemented by health care professionals to improve the connection between older people and their families.

CONCLUSIONS

Visitor restrictions have a high impact on the health and well-being of older adults' and their families. The main strategies and solutions employed to reduce social isolation and facilitate the communication between older adults' and their families were the use of information and communication technologies, family support groups, and the assignment of reference staff to each family.

CLINICAL IMPLICATIONS

The strategies and solutions mentioned should be internationally considered by health care providers in nursing homes to improve connections between family and older adults.

COVID-19 and loneliness: A rapid systematic review

BACKGROUND

Loneliness is known to be associated with both poorer physical and mental health, being associated with increased mortality. Responses throughout the world to the current COVID-19 pandemic all incorporate varying degrees of social distancing and isolation. There is an imperative to provide a timely review and synthesis of the impact of COVID-19 on loneliness in the general population.

METHODS

PubMed was searched using the key terms 'COVID-19', 'coronavirus', 'SARS-COV2' and 'loneliness'. Fifty-four articles were identified and screened against the inclusion criteria. The inclusion criteria stipulated that the study needed to incorporate a measure of loneliness with participants being drawn from the general adult population. Twenty-four studies met the inclusion criteria.

RESULTS

The key data extracted from the 24 reviewed studies are presented and summarised with a focus on key demographics of participants, the research designs utilised, the measures of loneliness employed and the other variables assessed in the studies. Overall, the findings indicate that loneliness has been a significant issue during the current COVID-19 pandemic and loneliness is positively associated with mental health symptoms. However, there were inconsistencies in the results evident across studies.

CONCLUSION

To our knowledge, this is the first systematic review of research investigating loneliness during the current COVID-19 pandemic in the general adult population. Despite the inconsistencies evident in some of the results across the studies, it is clearly apparent that loneliness is having an impact on the mental health and wellbeing of the general adult population. Furthermore, it is apparent that the current COVID-19 pandemic has had an impact on loneliness in the general adult population and that loneliness is significantly positively associated with mental illness symptomatology. Thus, there is an imperative to address loneliness through public policy and interventions. The limitations of this review are noted and directions given for future research.

Demographic and Psychographic Factors of Social Isolation During the COVID-19 Pandemic: The Importance of Technology Confidence

The COVID-19 pandemic presents an unprecedented situation in which physical distancing and “stay at home” orders have increased the pressures for social isolation. Critically, certain demographic factors have been linked to increased feelings of isolation and loneliness. These at-risk groups for social isolation may be disproportionately affected by the changes and restrictions that have been implemented to prevent viral spread. In our analysis, we sought to evaluate if perceived feelings of social isolation, during the COVID-19 pandemic, was related to demographic and technology-related psychographic characteristics. Older adults across Canada were surveyed about their demographic background, their feelings concerning confidence and proficiency in technology use, and how frequently they have felt isolated during the pandemic. In total 927 responses from Canadians over 65 years old, of varying demographic characteristics were collected. Our data shows that many older adults are feeling isolated “Often” or “Some of the time” in 2020, regardless of most demographic factors that have been previously associated with increased isolation risk. However, feelings of proficiency in using technology was an important factor affecting feelings of isolation. Given that technology proficiency is a modifiable factor, and remained significant after adjustment for demographic factors, future efforts to reduce social isolation should consider training programs for older adults to improve technology confidence, especially in an increasingly digital world.

Effect of a Social Networking Site Training on Cognitive Performance in Healthy Older People and Role of Personality Traits. Results from the Randomized Controlled Trial Ageing in a Networked Society-Social Experiment (ANS-SE) Study

OBJECTIVES

The study aimed to evaluate the short-term efficacy of social network sites (SNSs) training on cognitive performance in cognitively healthy older individuals, and to explore the influence of personality traits on cognitive benefits of SNSs training.

METHODS

The Aging in a Networked Society-Social Experiment study was a randomized controlled trial with three arms: intervention group (course on SNSs use), active control group (lifestyle education) and waiting list. Among the 180 eligible participants, 144 participated, 115 completed the study. The assessment comprised: Stroop Color and Word Test, Wechsler tests (Digit span, Symbol search, Coding), and Eysenck Personality Questionnaire- Revised- Short Form.

RESULTS

There was no significant cognitive improvement for treatment group versus the control groups. Time interference significantly worsened in lifestyle education group compared to the waiting list, after controlling for baseline test scores and personality traits.

CONCLUSION

The present study does not support the usefulness of SNSs training with healthy older adults. The educational content of lifestyle education is not an inert condition among individuals with high levels of neuroticism and socially desirable responding. There is a need to design experimental conditions in the control groups which do not influence participant's outcomes.

Well-Being and the COVID-19 Pandemic

Abstract. The purpose of this systematic review is to analyze the COVID-19 pandemic’s effects through the lens of community psychology. Our study applied PRISMA methodology, and it was carried out using the PsycInfo, PubMed, Embase, and EBSCO databases utilizing the keywords “connectedness,” “resilience,” “shared action,” “social action,” “trust,” “individual well-being,” and “social well-being.” We selected 12 of 216 eligible publications based on the inclusion criteria. The results indicated that the role of trust in institutions and others is a protective factor for communities that experience crises, such as the COVID-19 pandemic. Moreover, developing social actions promoted connections and social support and that, in the absence of in-person communication, online communication promoted connections and reduced psychological distress and isolation. Finally, the study revealed that some psychosocial factors stem from declines in people’s well-being due to the pandemic and subsequent lockdowns. Furthermore, our findings highlighted the role of technology as a positive communication tool for promoting connectedness and social support, as well as the social function of trust in institutions. Our results suggested that community interactions at the local and virtual levels should be viewed as positive actions to support institutions in detecting the most effective social intervention measures to stimulate individual and community well-being during the pandemic. These findings may serve as a guide for health policymakers in their efforts to face the effects of the COVID-19 pandemic supporting beneficial strategies for social planning and effective public policies. Finally, both the strengths and limitations of the research will be discussed in depth.

Using Technology the Right Way to Support Social Connectedness for Older People in the Era of COVID-19

The restrictions imposed in response to the COVID-19 pandemic pose significant risks to the human rights of older people from limitations in how people are able to engage with their social lives and from increased risk of discrimination linked to conceptualization of COVID-19 as a disease of the old. Further, COVID-19 increases risks of social isolation through public health and societal responses such as lockdowns. These responses have resulted in significant shifts in how citizens and service providers think about technology as a tool to allow people to stay socially connected. However, there are risks to the rights of older people inherent in the use of technology related to their ability to access technology and ageist assumptions that may limit engagement. The ‘Technology and Social Connectedness’ project was a pre-pandemic mixed-methods study involving evidence review, secondary analyses, and qualitative methods. Cross-dataset analyses led to evidence-based guidance to inform a rights-based approach to using technology. This paper provides analysis from the project that foregrounds a rights-based approach demonstrating how we developed the guidance within this framework and, contextualized within the pandemic response in Scotland, how that guidance can help others to protect and uphold the human rights of older people.

The Role of Social Connection/Engagement in Episodic Memory Change in Stroke

BACKGROUND AND OBJECTIVES

Positive associations between social connection/engagement and cognitive function are well documented. However, little is known about whether social connection/engagement can buffer the impact of serious brain injury such as stroke on cognitive functioning.

RESEARCH DESIGN AND METHODS

Participants were 898 individuals with incident stroke from the Health and Retirement Study (HRS) between 1998-2012. Multilevel modeling was used to examine how social connection/engagement were associated with episodic memory pre- and post-stroke. Models controlled for age, gender, education, race/ethnicity, number of health conditions, and functional health.

RESULTS

Participants who were lonely pre-stroke recalled significantly fewer words at time of stroke, and participants who had children residing within 10 miles pre-stroke showed significantly less decline in word recall over time. Participants who provided help to others pre-stroke showed less stroke-related decline in word recall. Within-person increase in partnered status, having friends, and helping others were related to better word recall in the post-stroke period.

DISCUSSION AND IMPLICATIONS

Higher pre-stroke levels of social connection/engagement predicted better episodic memory at stroke, smaller decline in episodic memory with stroke, and less decline in episodic memory over time. Increases in social connection/engagement from pre- to post-stroke also predicted better post-stroke episodic memory. Beyond the widely documented benefits of social connection/engagement to well-being, they may also increase cognitive stimulation and cognitive reserve and thus contribute to stroke recovery in the cognitive domain. Social connection/engagement is an important and modifiable risk factor in older adults.

Special Issue on "Advances in Socio-Economic Research on Ageing"

This Special Issue provides the readers of the International Journal of Environmental Research and Public Health a multidimensional overview of recent developments in the field of socio-economic gerontological research [...].

An Agile Digital Platform to Support Population Health-A Case Study of a Digital Platform to Support Patients with Delirium Using IoT, NLP, and AI

For an organization to be customer centric and service oriented requires that it use each encounter with a customer to create value, leverage advanced technologies to design digital services to fulfill the value, and assess perceived value-in-use to continue to revise the value as customer expectations evolve. The adaptation of value cycles to address the rapid changes in customer expectations requires agile digital platforms with dynamic software ecosystems interacting with multiple actors. For public health agencies focused on population health, these agile digital platforms should provide tailored care to address the distinct needs of select population groups. Using prior research on aging and dynamic software ecosystems, this paper develops a template for the design of an agile digital platform to support value cycle activities among clinical and non-clinical actors, including population groups. It illustrates the design of an agile digital platform to support clients that suffer from delirium, using digital services that leverage Internet of Things, natural language processing, and AI that uses real-time data for learning and care adaption. We conclude the paper with directions for future research.

Social support, perceived risk and the likelihood of COVID-19 testing and vaccination: cross-sectional data from the United Kingdom

Two samples of 227 and 214 adults completed surveys of social support, perceived risk of COVID-19 and COVID-19 preventive activity - in Study 1 likelihood of testing was examined and in Study 2 likelihood of both testing and vaccination were examined during the COVID-19 pandemic in the United Kingdom. Path analysis showed, in Study 1, that access to help (as an indicator of social support) had a direct effect on likelihood of testing and indirect effects through self-efficacy, perceived risk and preventive behavior; and, in Study 2, that neighborhood identification (as an indicator of social support) had a direct effect on likelihood of testing and indirect effects on likelihood of both testing and vaccination through the mediators of strength of social network, loneliness, perceived risk of COVID-19, and preventive activity. Both studies suggest that level of social support (conceptualized in different ways) is an important determinant of COVID-19 testing and Study 2 shows it is also a determinant of likelihood of vaccination. As resurgences of COVID-19 occur, it will be necessary to monitor the likelihood of COVID-19 testing and vaccination behaviors and, especially, to promote confidence in the latter in individuals with decreased access to social support.

Loneliness and Its Associated Factors Nine Months after the COVID-19 Outbreak: A Cross-National Study

COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local "social distancing" policies have on the daily lives of individuals. The aim of this study was to examine loneliness in relation to risk assessment, measures taken against risks, concerns, and social media use, while adjusting for sociodemographic variables. The cross-sectional study collected data from 3474 individuals from the USA, the UK, Norway, and Australia. Loneliness was measured with the de Jong Gierveld Loneliness Scale. Multiple linear regression was used in the analysis of associations between variables. The results showed that concerns about finances were more strongly associated with social loneliness, while concerns about the future was more strongly associated with emotional loneliness. Longer daily time spent on social media was associated with higher emotional loneliness. In conclusion, pandemic-related concerns seem to affect perceptions of loneliness. While social media can be used productively to maintain relationships, and thereby prevent loneliness, excessive use may be counterproductive.