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Aßmann ES, Ose J, Hathaway CA, Oswald LB, Hardikar S, Himbert C, Chellam V, Lin T, Daniels B, Kirchhoff AC, Gigic B, Grossman D, Tward J, Varghese TK, Shibata D, Figueiredo JC, Toriola AT, Beck A, Scaife C, Barnes CA, Matsen C, Ma DS, Colman H, Hunt JP, Jones KB, Lee CJ, Larson M, Onega T, Akerley WL, Li CI, Grady WM, Schneider M, Dinkel A, Islam JY, Gonzalez BD, Otto AK, Penedo FJ, Siegel EM, Tworoger SS, Ulrich CM, Peoples AR. Risk factors and health behaviors associated with loneliness among cancer survivors during the COVID-19 pandemic. J Behav Med 2024; 47:405-421. [PMID: 38418709 DOI: 10.1007/s10865-023-00465-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 12/27/2023] [Indexed: 03/02/2024]
Abstract
Loneliness may exacerbate poor health outcomes particularly among cancer survivors during the COVID-19 pandemic. Little is known about the risk factors of loneliness among cancer survivors. We evaluated the risk factors of loneliness in the context of COVID-19 pandemic-related prevention behaviors and lifestyle/psychosocial factors among cancer survivors. Cancer survivors (n = 1471) seen at Huntsman Cancer Institute completed a survey between August-September 2020 evaluating health behaviors, medical care, and psychosocial factors including loneliness during COVID-19 pandemic. Participants were classified into two groups: 'lonely' (sometimes, usually, or always felt lonely in past month) and 'non-lonely' (never or rarely felt lonely in past month). 33% of cancer survivors reported feeling lonely in the past month. Multivariable logistic regression showed female sex, not living with a spouse/partner, poor health status, COVID-19 pandemic-associated lifestyle factors including increased alcohol consumption and marijuana/CBD oil use, and psychosocial stressors such as disruptions in daily life, less social interaction, and higher perceived stress and financial stress were associated with feeling lonely as compared to being non-lonely (all p < 0.05). A significant proportion of participants reported loneliness, which is a serious health risk among vulnerable populations, particularly cancer survivors. Modifiable risk factors such as unhealthy lifestyle behaviors and psychosocial stress were associated with loneliness. These results highlight the need to screen for unhealthy lifestyle factors and psychosocial stressors to identify cancer survivors at increased risk of loneliness and to develop effective management strategies.
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Affiliation(s)
- Elena S Aßmann
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- School of Medicine, Technical University of Munich, Munich, Germany
| | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Cassandra A Hathaway
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Sheetal Hardikar
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Caroline Himbert
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Anne C Kirchhoff
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Pediatrics, Division of Hematology/Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Douglas Grossman
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Jonathan Tward
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA
| | - Thomas K Varghese
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - David Shibata
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jane C Figueiredo
- Department of Medicine, Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Adetunji T Toriola
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Anna Beck
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Courtney Scaife
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Christopher A Barnes
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Cindy Matsen
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Debra S Ma
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Howard Colman
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA
| | - Jason P Hunt
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Kevin B Jones
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Orthopedics, University of Utah, Salt Lake City, UT, USA
| | - Catherine J Lee
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Transplant and Cellular Therapy Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | | | - Tracy Onega
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Wallace L Akerley
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jessica Y Islam
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Amy K Otto
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
- Department of Public Health Sciences, University of Miami, Coral Gables, FL, USA
| | - Frank J Penedo
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL, USA
| | - Erin M Siegel
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Anita R Peoples
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
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Shekelle PG, Miake-Lye IM, Begashaw MM, Booth MS, Myers B, Lowery N, Shrank WH. Interventions to Reduce Loneliness in Community-Living Older Adults: a Systematic Review and Meta-analysis. J Gen Intern Med 2024; 39:1015-1028. [PMID: 38200279 DOI: 10.1007/s11606-023-08517-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/26/2023] [Indexed: 01/12/2024]
Abstract
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 ).
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Affiliation(s)
- Paul G Shekelle
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA.
- Division of General Internal Medicine & Health Services Research, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- General Internal Medicine 111G, West Los Angeles VA Medical Center, Los Angeles, CA, USA.
| | - Isomi M Miake-Lye
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Meron M Begashaw
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
| | - Marika S Booth
- RAND Corporation, Southern California Evidence-Based Practice Center, Santa Monica, CA, USA
| | - Bethany Myers
- Louise M. Darling Biomedical Library, University of California Los Angeles, Los Angeles, CA, USA
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Mouriño-Ruiz R, Serral G, Continente X, López MJ, Lapena C, Puigpinós-Riera R. Evaluation of effectiveness of an art-based museum intervention in reducing loneliness among older adults (ArtGran): a quasi-experimental study. Public Health 2024; 230:149-156. [PMID: 38552347 DOI: 10.1016/j.puhe.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES Loneliness is a public health issue among older adults. We designed an intervention offering 10 sessions with diverse artistic methods (ArtGran). This study assessed the effectiveness of ArtGran in reducing loneliness and its negative effects on health in community-dwelling older adults in 2022 in Barcelona. STUDY DESIGN Quasi-experimental study, with an intervention group (IG) and a comparison group (CG). METHODS The sample included residents aged ≥70 years from 6 selected neighbourhoods of Barcelona. In each neighbourhood, an IG and a CG was formed with participants who reported loneliness and without special mobility needs. The participants were referred from primary care centres, social services, and community health centres. We included 138 participants (IG = 63, CG = 75). We collected data on loneliness, quality of life (QoL-5D), mood, and self-perceived health before and after the intervention through validated questionnaires. To assess the effect of the intervention, we built Poisson models with robust variance and linear regression models. RESULTS At the end of the intervention, participants in the IG were more likely than those in the CG to be able to perform their usual activities without problems (adjusted prevalence ratio [aPR] = 1.22; 95% confidence interval [CI]: 1.02-1.45). Compared with the CG, participants in the IG attending more than half of the sessions had lower levels of loneliness (aPR = 1.36; 95%CI: 1.07-1.73), a better ability to perform their usual activities (aPR [95%CI] = 1.24 [1.05-1.48]), and higher happiness scores (β = 0.73; P = 0.01). CONCLUSIONS The effectiveness of the intervention was more pronounced when participants had high attendance. Our results suggest that high attendance of the ArtGran program was helpful in shielding older individuals from loneliness, fostering positive moods, and preserving their functional status.
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Affiliation(s)
- R Mouriño-Ruiz
- Evaluation and Intervention Methods Service, Public Health Agency of Barcelona, Barcelona, Catalonia
| | - G Serral
- Evaluation and Intervention Methods Service, Public Health Agency of Barcelona, Barcelona, Catalonia; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Catalonia
| | - X Continente
- Evaluation and Intervention Methods Service, Public Health Agency of Barcelona, Barcelona, Catalonia; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Catalonia
| | - M J López
- Evaluation and Intervention Methods Service, Public Health Agency of Barcelona, Barcelona, Catalonia; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Catalonia; Department of Experimental and Health Sciences at Universitat Pompeu Fabra, Barcelona, Catalonia
| | - C Lapena
- Primary Care Center Sanllehy, Gerència Territorial de Barcelona, Catalan Health Institute (ICS), Barcelona, Catalonia; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Catalonia
| | - R Puigpinós-Riera
- Evaluation and Intervention Methods Service, Public Health Agency of Barcelona, Barcelona, Catalonia; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Catalonia.
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Castillo-Hornero A, Rojano-Hidalgo M, López A, Alarcón A, Belmonte O, Caballer A. Reminiscence interventions for loneliness reduction in older adults: a systematic review. Aging Ment Health 2024:1-11. [PMID: 38669147 DOI: 10.1080/13607863.2024.2345809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES This study aims to review the use of reminiscence interventions in the reduction of loneliness in older adults by categorising the interventions by type, and comparing their effectiveness and methodological quality. METHOD This is a systematic review following PRISMA guidelines. The search was restricted to studies published in the Cochrane, CINAHL, Web of Science, Psycarticles, Psycinfo, and PubMed databases until December 2022. The inclusion criteria for the studies included in this review were: 1) reminiscence intervention 2) loneliness outcome measure 3) adults over 60 years old 4) experimental, pre-experimental, and quasi-experimental studies. RESULTS A total of twelve studies were eligible for inclusion. Only nine studies included a control group, and seven of those report significant effectiveness in reducing loneliness levels. The most popular type of intervention is simple reminiscence and life review, and in-group format. The interventions to date have been very heterogeneous, and the methodological quality of the existing literature is moderate to weak. CONCLUSION While reminiscence interventions hold some promise for reducing loneliness levels among older adults, future methodologically rigorous research is required, and standardised protocols need to be developed for application, with the specific aim of reducing levels of loneliness among older adults.
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Affiliation(s)
- Andrea Castillo-Hornero
- Department of Computer Languages and Systems, Institute of New Imaging Technologies, University Jaume I, Castellón de la Plana, Spain
| | - Mario Rojano-Hidalgo
- Department of Developmental Educational and Social Psychology and Methodology, University Jaume I, Castellón de la Plana, Spain
| | - Agustín López
- Department of Developmental Educational and Social Psychology and Methodology, University Jaume I, Castellón de la Plana, Spain
| | - Ana Alarcón
- Department of Developmental Educational and Social Psychology and Methodology, University Jaume I, Castellón de la Plana, Spain
| | - Oscar Belmonte
- Department of Computer Languages and Systems, Institute of New Imaging Technologies, University Jaume I, Castellón de la Plana, Spain
| | - Antonio Caballer
- Department of Developmental Educational and Social Psychology and Methodology, University Jaume I, Castellón de la Plana, Spain
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Tache-Codreanu DL, Tache-Codreanu A. Acting and Dancing during the COVID-19 Pandemic as Art Therapy for the Rehabilitation of Children with Behavioural Disorders Living in Socially Disadvantaged Environments. Children (Basel) 2024; 11:461. [PMID: 38671678 PMCID: PMC11049469 DOI: 10.3390/children11040461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/23/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
Art therapy is employed in numerous ways in rehabilitation. This study focuses on an art and movement therapy project carried out during the COVID-19 pandemic. Acting and dancing methods were adapted to produce a short musical film series for ten children from disadvantaged social backgrounds displaying nonorganic behavioural disorders. The aim was to acquire novel ways of expression on the part of the participants to release painful emotions in a safe setting using the method of catharsis through acting and dancing, triggering relaxation as a physiological response and improving their attitude. This study retrospectively analyses the changes in the children's behaviour and their active participation in the project through quantitative and qualitative research. The children improved their attention and self-esteem, their behaviour became less aggressive and impulsive, and half showed increased empathy. The active participation rate during the project was 82%.
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Affiliation(s)
- Diana-Lidia Tache-Codreanu
- Neurorehabilitation Research Laboratory, Medical Rehabilitation Department, Colentina Clinical Hospital, 19–21 Stefan cel Mare Street, 020125 Bucharest, Romania;
| | - Andrei Tache-Codreanu
- Doctoral School, The National University of Theatre and Film “I.L. Caragiale”, 75–77 Matei Voievod Street, 021452 Bucharest, Romania
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Langergaard S, Evans R, Andreasen J, Petersen KS, Overgaard C. Targeting belongingness among older people through engagement in senior centres: intervention development study in Denmark. Health Promot Int 2024; 39:daae032. [PMID: 38610110 PMCID: PMC11015047 DOI: 10.1093/heapro/daae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024] Open
Abstract
Adults often experience a loss of social relations and sense of belonging in later life, leading to the risk of social isolation. Municipal senior centres offer a potential site for intervention, as they provide social communities targeting older people. However, not all older people find it easy to access these social communities due to experiencing physical and/or psychosocial frailties and could therefore continue to experience a decline in social relations and sense of belonging, which potentiates poor physical and psychosocial health and well-being. To date, there are limited evidence-based interventions in Denmark. The present article describes the development of an intervention to increase belongingness and decrease social isolation among older people with frailties who attend Danish municipal senior centres. The development process was conducted with reference to the INDEX (IdentifyiNg and assessing different approaches to DEveloping compleX intervention) guidance. The development process resulted in a 6-month supportive intervention, consisting of four elements: skills development workshops for all staff members; a start conversation including frailty screening; allocation of a 'buddy' among existing service users; and monthly follow-up conversations with staff members. This theory-informed approach can progress to feasibility testing and outcome evaluation in order to generate an evidence base. Concurrently, the article reflects on current guidance for intervention development and how it may be used and optimized to strengthen developmental processes in the future.
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Affiliation(s)
- Sofie Langergaard
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerloefs Vej 249, 9260 Gistrup, Aalborg, Denmark
| | - Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Jane Andreasen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerloefs Vej 249, 9260 Gistrup, Aalborg, Denmark
- Aalborg Centre of Health and Rehabilitation, Aalborg Municipality, Teglgårds Plads 1, 9000 Aalborg, Denmark
| | - Kirsten Schultz Petersen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerloefs Vej 249, 9260 Gistrup, Aalborg, Denmark
| | - Charlotte Overgaard
- Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Degnevej 14, 6705 Esbjerg Ø, Denmark
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Rodriguez AK, Akram S, Colverson AJ, Hack G, Golden TL, Sonke J. Arts Engagement as a Health Behavior: An Opportunity to Address Mental Health Inequities. Community Health Equity Res Policy 2024; 44:315-322. [PMID: 37196338 DOI: 10.1177/2752535x231175072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The significance of mental health inequities globally is illustrated by higher rates of anxiety and depression amongst racial and ethnic minority populations as well as individuals of lower socioeconomic status. The COVID-19 pandemic has further exacerbated these pre-existing mental health inequities. With rising mental health concerns, arts engagement offers an accessible, equitable opportunity to combat mental health inequities and impact upstream determinants of health. As the field of public health continues to shift its focus toward social ecological strategies, the social ecological model of health offers an approach that prioritizes social and structural determinants of health. To capture the impacts of arts engagement, this paper creates an applied social ecological model of health while aiming to advocate that engaging in the arts is a protective and rehabilitative behavior for mental health.
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Affiliation(s)
- Alexandra K Rodriguez
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
- University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - Seher Akram
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Aaron J Colverson
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
- University of Florida Musicology/Ethnomusicology Program, Gainesville, FL, USA
| | - George Hack
- University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - Tasha L Golden
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
- International Arts + Mind Lab, Brain Science Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jill Sonke
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
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Schoenmakers EC, Lasgaard M, McHugh Power J. Guidelines for evaluating and reporting social isolation and loneliness interventions. J Health Psychol 2024:13591053241238127. [PMID: 38527950 DOI: 10.1177/13591053241238127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Given the unpleasant nature of social isolation and loneliness (SIL) and their negative effects on health and wellbeing, interventions are needed. However, persistent issues in the design, evaluation, and reporting of SIL interventions preclude conclusive evidence and commentary on the effectiveness of SIL interventions. Here, we propose guidelines for evaluating SIL interventions, firstly by operationalising them into two categories: (1) interventions aiming to reduce SIL as a primary outcome and (2) interventions aiming to improve non-SIL outcomes in the lives of individuals experiencing SIL. Secondly, we evaluate instruments for measuring SIL and research designs for studying intervention effectiveness. Thirdly, guidelines for reporting information about the intervention, study design, results, and discussion in SIL intervention studies are presented. These guidelines will help researchers to better and more consistently report on SIL interventions and improve comparability of SIL interventions, ultimately contributing to the improvement of interventions and to the mitigation of SIL.
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Yazdani N, Falzarano F, Minahan Zucchetto J, Siedlecki KL. COVID-19 Pandemic-Related Stress and Subjective Well-Being Across Age: The Mediating Role of Social Resources. Int J Aging Hum Dev 2024:914150241240122. [PMID: 38504624 DOI: 10.1177/00914150241240122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Stress associated with the COVID-19 pandemic and the measures implemented to prevent its spread dramatically shifted our social networks, interactions, and contexts, all of which influence the assessment of one's subjective well-being (SWB). Drawing on data collected from 1,318 adults between April and May 2020, we used structural equation modeling to analyze the relationship between pandemic-related stress and SWB (life satisfaction, positive affect, negative affect), and examined how these relationships vary across age. Pandemic-related stress was associated with lower life satisfaction and higher negative affect. However, no evidence of age moderation emerged. Subsequent analysis examined different aspects of social resources as potential mediating variables. Loneliness fully mediated the relationship between stress and life satisfaction, while social support demonstrated evidence of partial mediation. Further, loneliness and social support partially mediated the relationship between stress and negative affect. Findings suggest that pandemic-related stress impacts SWB, and social resources help explain these impacts.
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Affiliation(s)
- Neshat Yazdani
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Francesca Falzarano
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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Marziali RA, Franceschetti C, Dinculescu A, Nistorescu A, Kristály DM, Moșoi AA, Broekx R, Marin M, Vizitiu C, Moraru SA, Rossi L, Di Rosa M. Reducing Loneliness and Social Isolation of Older Adults Through Voice Assistants: Literature Review and Bibliometric Analysis. J Med Internet Res 2024; 26:e50534. [PMID: 38498039 PMCID: PMC10985600 DOI: 10.2196/50534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/13/2023] [Accepted: 11/24/2023] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Loneliness and social isolation are major public health concerns for older adults, with severe mental and physical health consequences. New technologies may have a great impact in providing support to the daily lives of older adults and addressing the many challenges they face. In this scenario, technologies based on voice assistants (VAs) are of great interest and potential benefit in reducing loneliness and social isolation in this population, because they could overcome existing barriers with other digital technologies through easier and more natural human-computer interaction. OBJECTIVE This study aims to investigate the use of VAs to reduce loneliness and social isolation of older adults by performing a systematic literature review and a bibliometric cluster mapping analysis. METHODS We searched PubMed, Embase, and Scopus databases for articles that were published in the last 6 years, related to the following main topics: voice interface, VA, older adults, isolation, and loneliness. A total of 40 articles were found, of which 16 (40%) were included in this review. The included articles were then assessed through a qualitative scoring method and summarized. Finally, a bibliometric analysis was conducted using VOSviewer software (Leiden University's Centre for Science and Technology Studies). RESULTS Of the 16 articles included in the review, only 2 (13%) were considered of poor methodological quality, whereas 9 (56%) were of medium quality and 5 (31%) were of high quality. Finally, through bibliometric analysis, 221 keywords were extracted, of which 36 (16%) were selected. The most important keywords, by number of occurrences and by total link strength; results of the analysis with the Association Strength normalization method; and default values were then presented. The final bibliometric network consisted of 36 selected keywords, which were grouped into 3 clusters related to 3 main topics (ie, VA use for social isolation among older adults, the significance of age in the context of loneliness, and the impact of sex factors on well-being). For most of the selected articles, the effect of VA on social isolation and loneliness of older adults was a minor theme. However, more investigations were done on user experience, obtaining preliminary positive results. CONCLUSIONS Most articles on the use of VAs by older adults to reduce social isolation and loneliness focus on usability, acceptability, or user experience. Nevertheless, studies directly addressing the impact that using a VA has on the social isolation and loneliness of older adults find positive and promising results and provide important information for future research, interventions, and policy development in the field of geriatric care and technology.
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Affiliation(s)
- Rachele Alessandra Marziali
- Centre for Innovative Models for Aging Care and Technology, IRCCS INRCA-National Institute of Health and Science on Aging, Ancona, Italy
| | - Claudia Franceschetti
- Centre for Innovative Models for Aging Care and Technology, IRCCS INRCA-National Institute of Health and Science on Aging, Ancona, Italy
| | - Adrian Dinculescu
- The Space Applications and Technologies Laboratory, Institute of Space Science - Subsidiary of INFLPR (National Institute for Laser, Plasma and Radiation Physics), Magurele, Romania
| | - Alexandru Nistorescu
- The Space Applications and Technologies Laboratory, Institute of Space Science - Subsidiary of INFLPR (National Institute for Laser, Plasma and Radiation Physics), Magurele, Romania
| | - Dominic Mircea Kristály
- Department of Automatics and Information Technology, Faculty of Electrical Engineering and Computer Science, Transilvania University of Brasov, Brasov, Romania
| | - Adrian Alexandru Moșoi
- Department of Psychology and Education Sciences, Faculty of Psychology and Education Sciences, Transilvania University of Brasov, Brasov, Romania
| | | | - Mihaela Marin
- The Space Applications and Technologies Laboratory, Institute of Space Science - Subsidiary of INFLPR (National Institute for Laser, Plasma and Radiation Physics), Magurele, Romania
| | - Cristian Vizitiu
- The Space Applications and Technologies Laboratory, Institute of Space Science - Subsidiary of INFLPR (National Institute for Laser, Plasma and Radiation Physics), Magurele, Romania
- Department of Automatics and Information Technology, Faculty of Electrical Engineering and Computer Science, Transilvania University of Brasov, Brasov, Romania
| | - Sorin-Aurel Moraru
- Department of Automatics and Information Technology, Faculty of Electrical Engineering and Computer Science, Transilvania University of Brasov, Brasov, Romania
| | - Lorena Rossi
- Centre for Innovative Models for Aging Care and Technology, IRCCS INRCA-National Institute of Health and Science on Aging, Ancona, Italy
| | - Mirko Di Rosa
- Centre for Biostatistics and Applied Geriatric Clinical Epidemiology, IRCCS INRCA-National Institute of Health and Science on Aging, Ancona, Italy
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11
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Hsu HC, Chang SC, Liang CY, Ting JR. Intervention to reduce loneliness among older adults in the community: Making friends with volunteers. Geriatr Gerontol Int 2024; 24 Suppl 1:240-245. [PMID: 38323733 DOI: 10.1111/ggi.14828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/08/2024]
Abstract
AIM This study aimed to examine the effects of providing a program that introduced volunteers to make friends with older adults to reduce loneliness and increase loneliness literacy. METHODS Eight community development associations in Taiwan participated in the study. In the first stage, older people living alone or with only a spouse, or those with a family, but without substantial interactions, were screened for loneliness. Older adults with a higher risk of loneliness were given priority to be invited to participate in this intervention. This 3-month intervention program was designed by each community development association and delivered at the older adults' homes. A total of 87 older persons completed both waves of the interviews. RESULTS Loneliness was reduced (UCLA-6 Loneliness Scale scores decreased from 13.5 to 11.6), and loneliness literacy improved (loneliness literacy scores increased from 38.9 to 42.0) compared with what it was before the program. In a generalized linear model, when controlling for covariates, loneliness was reduced, but not significantly (B = -0.934, P > 0.05), whereas loneliness literacy improved significantly for older participants (B = 2.088, P < 0.05). CONCLUSIONS Making friends with older adults who are lonely might improve their loneliness literacy. Geriatr Gerontol Int 2024; 24: 240-245.
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Affiliation(s)
- Hui-Chuan Hsu
- School of Public Health, Taipei Medical University, Taipei, Taiwan
| | | | - Chun-Yu Liang
- Federation for the Welfare of the Elderly, Taipei, Taiwan
| | - Jie-Rong Ting
- School of Public Health, Taipei Medical University, Taipei, Taiwan
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12
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Hughes G, Moore L, Hennessy M, Sandset T, Jentoft EE, Haldar M. What kind of a problem is loneliness? Representations of connectedness and participation from a study of telepresence technologies in the UK. Front Digit Health 2024; 6:1304085. [PMID: 38440196 PMCID: PMC10910053 DOI: 10.3389/fdgth.2024.1304085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
Loneliness is represented in UK policy as a public health problem with consequences in terms of individual suffering, population burden and service use. However, loneliness is historically and culturally produced; manifestations of loneliness and social isolation also require social and cultural analysis. We explored meanings of loneliness and social isolation in the UK 2020-2022 and considered what the solutions of telepresence technologies reveal about the problems they are used to address. Through qualitative methods we traced the introduction and use of two telepresence technologies and representations of these, and other technologies, in policy and UK media. Our dataset comprises interviews, fieldnotes, policy documents, grey literature and newspaper articles. We found loneliness was represented as a problem of individual human connection and of collective participation in social life, with technology understood as having the potential to enhance and inhibit connections and participation. Technologically-mediated connections were frequently perceived as inferior to in-person contact, particularly in light of the enforced social isolation of the COVID-19 pandemic. We argue that addressing loneliness requires attending to other, related, health and social problems and introducing technological solutions requires integration into the complex social and organisational dynamics that shape technology adoption. We conclude that loneliness is primarily understood as a painful lack of co-presence, no longer regarded as simply a subjective experience, but as a social and policy problem demanding resolution.
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Affiliation(s)
- Gemma Hughes
- School of Business, University of Leicester, Leicester, United Kingdom
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Lucy Moore
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Megan Hennessy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Tony Sandset
- Centre for Sustainable Healthcare Education, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elian E. Jentoft
- Centre for the Study of Digitalization of Public Services and Citizenship, Oslo Metropolitan University, Oslo, Norway
| | - Marit Haldar
- Centre for the Study of Digitalization of Public Services and Citizenship, Oslo Metropolitan University, Oslo, Norway
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13
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Ulichney V, Schmidt H, Helion C. Perceived Relational Support Is Associated With Everyday Positive, But Not Negative, Affectivity in a U.S. Sample. Pers Soc Psychol Bull 2024:1461672231224991. [PMID: 38323578 DOI: 10.1177/01461672231224991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Research suggests that perceived social support bolsters emotional well-being. We tested whether perceived support from friends, family, and spouses/partners was associated with reduced negative and greater positive affectivity (i.e., everyday affective baseline), and whether perceived strain in these relationships had opposite effects, accounting for age and relevant covariates. Using data from the third waves of the Midlife in the United States survey and National Study of Daily Experience (n = 1,124), we found negative affectivity was not tied to relational support nor strain, but instead was associated positively with neuroticism and negatively with conscientiousness. In contrast, positive affectivity was related positively to support from friends and family, conscientiousness, and extroversion, and negatively to strain among partners and neuroticism. Exploratory analyses within second-wave Midlife in Japan data (n = 657) suggest patterns for future cross-cultural study. Some relationship dynamics may vary, but perceived support might enhance emotional well-being by bolstering positive, rather than mitigating negative, emotionality.
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14
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Morikawa M, Lee S, Makino K, Harada K, Katayama O, Tomida K, Yamaguchi R, Nishijima C, Fujii K, Misu Y, Shimada H. Social isolation and risk of disability in older adults: Effect modification of metabolic syndrome. Arch Gerontol Geriatr 2024; 116:105209. [PMID: 37782966 DOI: 10.1016/j.archger.2023.105209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE Delaying the onset of disabilities is a social challenge, especially in an aging society. Social isolation (SI) and metabolic syndrome (MetS) can coexist and pose the risks of disability onset. However, their interaction is not proven in older adults. Therefore, this study investigated whether SI combined with MetS exacerbates disability onset in older adults. MATERIALS AND METHODS A total of 3,738 community-dwelling older adults underwent a health check-up. After baseline assessments, we followed them up to assess disability incidence for five years. SI was defined as a condition in which two or more of the following measures were met: domestic isolation, less social contact, and social disengagement. MetS was defined according to the criteria of the International Diabetes Federation. We used Cox proportional hazard regression used to identify the interaction effect of SI and MetS on the risk of disability onset after adjusting for potential confounding factors. RESULTS Multivariate Cox proportional hazard regression showed a significant interaction effect of SI and MetS on disability onset. In the subgroup analysis stratified by MetS status, SI was identified as a risk factor for disability onset only in the MetS group, but not in the non-MetS group. CONCLUSIONS This five-year longitudinal study showed that the co-occurrence of SI and MetS increased the risk of disability onset in older adults. This indicates that the assessment of MetS in socially isolated older adults is important for healthcare providers to delay the onset of disabilities.
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Affiliation(s)
- Masanori Morikawa
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Sangyoon Lee
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Keitaro Makino
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Kenji Harada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Osamu Katayama
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Kouki Tomida
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Ryo Yamaguchi
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Chiharu Nishijima
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Kazuya Fujii
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Yuka Misu
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
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15
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Weldrick R, Dunn JR, Andrews GJ, Ploeg J. Friendly Visiting Programs for Older People Experiencing Social Isolation: A Realist Review of what Works, for whom, and under what Conditions. Can J Aging 2023; 42:538-550. [PMID: 37551541 DOI: 10.1017/s0714980823000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Many social interventions have been developed with the hopes of reducing and preventing social isolation among older people (e.g., recreation, arts-based programs and social prescription). Friendly visiting programs, also known as befriending schemes, have been a mainstay in this area for decades and are largely thought to be effective at reconnecting older people (≥ 60 years of age) experiencing isolation. Research and evaluations have yet to determine, however, how and why these programs may be most successful, and under what conditions. This article presents the findings of a realist synthesis aimed at identifying the critical mechanisms and contextual factors that lead to successful outcomes in friendly visiting programs. Seven studies are synthesized to inform a friendly visiting program theory accounting for key mechanisms (e.g., provision of informal support) and underlying contexts (e.g., training of volunteers) that can be used to inform future programs. Recommendations for future research are also presented.
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Affiliation(s)
- Rachel Weldrick
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
- School of Urban and Regional Planning, Toronto Metropolitan University, Toronto, ON, Canada
| | - James R Dunn
- Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Gavin J Andrews
- Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, ON, Canada
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16
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Welch V, Ghogomu ET, Barbeau VI, Dowling S, Doyle R, Beveridge E, Boulton E, Desai P, Huang J, Elmestekawy N, Hussain T, Wadhwani A, Boutin S, Haitas N, Kneale D, Salzwedel DM, Simard R, Hébert P, Mikton C. Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map. Campbell Syst Rev 2023; 19:e1369. [PMID: 38024780 PMCID: PMC10681039 DOI: 10.1002/cl2.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background Social isolation and loneliness are more common in older adults and are associated with a serious impact on their well-being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID-19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID-19 restrictions. Objectives To map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings. Search Methods We searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos. Selection Criteria Titles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria. Data Collection and Analysis We developed and pilot tested a data extraction code set in Eppi-Reviewer and data were individually extracted and coded based on an intervention-outcome framework which was also used to define the dimensions of the evidence and gap map. Main Results We included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID-19 pandemic. The evidence is unevenly distributed with clusters predominantly in high-income countries and none in low-income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at-risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS-Plus categories. Authors' Conclusions The restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high-quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.
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Affiliation(s)
- Vivian Welch
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Sierra Dowling
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | - Ella Beveridge
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Elisabeth Boulton
- School of Health Sciences, Division of Nursing, Midwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Payaam Desai
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Jimmy Huang
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Arpana Wadhwani
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Dylan Kneale
- Social Science Research Unit, EPPI‐Centre, UCL Institute of EducationUniversity College LondonLondonUK
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Paul Hébert
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
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17
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Joo S, Lee Y, Kim HK. Characterizing different patterns of digital competence and their associations with loneliness and social isolation among older adults: findings from South Korea. Aging Ment Health 2023:1-8. [PMID: 37938112 DOI: 10.1080/13607863.2023.2277872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVES With the advent of worldwide internet networks in the digital age, digital competence can play an important role in decreasing loneliness and social isolation in older adults. This study characterized different patterns of digital competence among older adults and examined their associations with loneliness and social isolation. METHOD The sample included 315 older Korean adults (M = 68.79, range = 65-84) who completed an online survey. RESULTS Latent profile analysis identified four different profiles of digital competence, including 1) low activity (28%) who did not choose digital participation despite advanced technical skills, 2) unskilled (13%) who had limited technical skills, 3) passive participation (25%) who was motivated for digital interactions even with insufficient technical skills, and 4) active participation (34%) who were involved in digital activities with the necessary skills. Additionally, the unskilled profile had relatively higher levels of loneliness than did the active participation profile. The passive participation and low activity profiles showed the highest level of social isolation, followed by the unskilled, and active participation profiles. CONCLUSION The present findings suggest that understanding different profiles of digital competence and facilitating active digital participation related to specific profiles can be an effective strategy to reduce older adults' social isolation and loneliness.
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Affiliation(s)
- Susanna Joo
- BK21 Symbiotic Society and Design, Yonsei University, Seoul, South Korea
| | - Yeseul Lee
- Department of Child and Family Studies/Human Life and Innovation Design, Yonsei University, Seoul, South Korea
| | - Hyoun K Kim
- Department of Child and Family Studies/Human Life and Innovation Design, Yonsei University, Seoul, South Korea
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18
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Kenyon K, Kinakh V, Harrison J. Social virtual reality helps to reduce feelings of loneliness and social anxiety during the Covid-19 pandemic. Sci Rep 2023; 13:19282. [PMID: 37935718 PMCID: PMC10630518 DOI: 10.1038/s41598-023-46494-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/31/2023] [Indexed: 11/09/2023] Open
Abstract
Evidence shows that the Covid-19 pandemic caused increased loneliness, anxiety and greater social isolation due to social distancing policies. Virtual reality (VR) provides users with an easy way to become engaged in social activities without leaving the house. This study focused on adults, who were socialising in Altspace VR, a social VR platform, during the Covid-19 pandemic and it explored whether social VR could alleviate feelings of loneliness and social anxiety. A mixed-methods research design was applied. Participants (n = 74), aged 18-75, completed a questionnaire inside the social VR platform to measure levels of loneliness (UCLA 20-item scale) and social anxiety (17-item SPIN scale) in the social VR platform (online condition) and real world (offline condition). Subsequently, a focus group (n = 9) was conducted to gather insights into how and why participants were using the social VR platform. Findings from the questionnaire revealed significantly lower levels of loneliness and social anxiety when in the social VR platform. Lower levels of loneliness and social anxiety were also associated with participants who socialised with a regular group of friends. In addition, findings from the focus group suggested that being part of an online group facilitates stronger feelings of belonging. Social VR can be used as a valuable intervention to reduce feelings of loneliness and social anxiety. Future studies should continue to establish whether social VR can help to encourage group formation and provide people with enhanced social opportunities beyond the COVID-19 pandemic.
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Affiliation(s)
- Keith Kenyon
- School of Psychology, Faculty of Health and Wellbeing, University of Bolton, Deane Road, Bolton, BL3 5AB, UK.
| | - Vitalia Kinakh
- Faculty of Biology, Medicine and Health, The University of Manchester, Coupland Building 3, Oxford Road, Manchester, M13 9PL, UK.
| | - Jacqui Harrison
- School of Psychology, Faculty of Health and Wellbeing, University of Bolton, Deane Road, Bolton, BL3 5AB, UK.
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19
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Zhang J, Sun X, Yao A. Use of home and community-based services and loneliness in older people with functional limitations: a cross-sectional study. BMC Psychiatry 2023; 23:717. [PMID: 37794343 PMCID: PMC10548717 DOI: 10.1186/s12888-023-05225-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Loneliness is one of the major health problems among older adults. Among this population, home and community-based services (HCBS) have become increasingly popular. Despite its health benefits, little is known about the relationship between HCBS use and loneliness in older people with functional limitations. We aim to explore the characteristics of loneliness among older people with functional limitations and examine the association between HCBS use and loneliness in China. METHODS We used a cross-sectional data from the 2018 China Health and Retirement Longitudinal Study, which includes a nationally representative sample of Chinese residents aged 65 and older with functional limitations. Logistic regression models were used to examine the associations between HCBS use and loneliness, and we further used propensity score matching to address potential sample selection bias. RESULT In China, 46% of older people with functional limitations felt lonely and only 22% of older people with functional limitations reported using HCBS in 2018. Compared with participants who did not receive HCBS, those who received HCBS were less likely to report loneliness (OR = 0.81, 95% CI = 0.63, 0.99, p = 0.048), and the results remained significant after addressing sample selection bias using propensity score matching. CONCLUSION Our results showed that loneliness was common among Chinese older people with functional limitations, and the proportion of HCBS use was low. There was robust evidence to support that among older people with functional limitations, HCBS use was associated with decreased loneliness. Further policies should promote the development of broader HCBS use for older people with functional limitations to reduce their loneliness.
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Affiliation(s)
- Jinxin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Rd, Jinan, Shandong, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Rd, Jinan, Shandong, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Aaron Yao
- Home Centered Care Institute, Schaumburg, IL, USA
- University of Virginia, Charlottesville, VA, USA
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Balta M, Katsas K, Grigoropoulou C, Diamantis DV, Kalogiannis D, Drougos N, Fagogeni E, Veloudaki A, Panagiotakos D, Linos A. Combating Loneliness in Older Adults during the COVID-19 Pandemic: Findings from a Volunteer-Based Program in Greece. Behav Sci (Basel) 2023; 13:804. [PMID: 37887454 PMCID: PMC10604287 DOI: 10.3390/bs13100804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/26/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
The COVID-19 pandemic has exacerbated the feeling of loneliness, especially among older adults. This study aims to investigate any association between COVID-19 cases in Greece and the number of Loneliness Helpline calls at the Friendship at Every Age program and to assess whether the interconnection part of the program, which interconnects older adults with volunteers, can combat loneliness/social isolation in older adults. This is a supportive, volunteer-based, social intervention program. A total of 4033 calls were collected from July 2020 to November 2022, in Greece. Older adults who participated in the interconnection part completed baseline (n = 275) and follow-up questionnaires (n = 168), including the UCLA Loneliness Scale. A time-series analysis revealed a positive association in the number of calls with COVID-19 cases (Incidence Rate Ratio per 100 new COVID-19 cases = 1.012; Confidence Interval (95% CI) [1.002, 1.022]). A significant decrease in the Loneliness Scale was observed at follow-up [difference = -0.85; 95% CI (-1.16, -0.54)], with similar results by sex, educational level, and area of living. Loneliness Helpline calls increased during COVID-19 outbreaks, while the interconnection part had a positive impact on older adults, reducing their feeling of loneliness. Similar initiatives are required to better address the needs of the ageing population during and after health crises.
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Affiliation(s)
- Marianna Balta
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 7 Fragoklisias Street, 151 25 Marousi, Greece; (M.B.); (C.G.); (D.V.D.); (D.K.); (N.D.); (E.F.); (A.V.); (A.L.)
| | - Konstantinos Katsas
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 7 Fragoklisias Street, 151 25 Marousi, Greece; (M.B.); (C.G.); (D.V.D.); (D.K.); (N.D.); (E.F.); (A.V.); (A.L.)
- Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Chrysoula Grigoropoulou
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 7 Fragoklisias Street, 151 25 Marousi, Greece; (M.B.); (C.G.); (D.V.D.); (D.K.); (N.D.); (E.F.); (A.V.); (A.L.)
| | - Dimitrios V. Diamantis
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 7 Fragoklisias Street, 151 25 Marousi, Greece; (M.B.); (C.G.); (D.V.D.); (D.K.); (N.D.); (E.F.); (A.V.); (A.L.)
| | - Dimitrios Kalogiannis
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 7 Fragoklisias Street, 151 25 Marousi, Greece; (M.B.); (C.G.); (D.V.D.); (D.K.); (N.D.); (E.F.); (A.V.); (A.L.)
| | - Nikolaos Drougos
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 7 Fragoklisias Street, 151 25 Marousi, Greece; (M.B.); (C.G.); (D.V.D.); (D.K.); (N.D.); (E.F.); (A.V.); (A.L.)
| | - Eleni Fagogeni
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 7 Fragoklisias Street, 151 25 Marousi, Greece; (M.B.); (C.G.); (D.V.D.); (D.K.); (N.D.); (E.F.); (A.V.); (A.L.)
| | - Afroditi Veloudaki
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 7 Fragoklisias Street, 151 25 Marousi, Greece; (M.B.); (C.G.); (D.V.D.); (D.K.); (N.D.); (E.F.); (A.V.); (A.L.)
| | - Demosthenes Panagiotakos
- School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave., 176 70 Athens, Greece;
| | - Athena Linos
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 7 Fragoklisias Street, 151 25 Marousi, Greece; (M.B.); (C.G.); (D.V.D.); (D.K.); (N.D.); (E.F.); (A.V.); (A.L.)
- Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
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21
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Hirai K, Tanaka A, Oda N, Kaneko K, Uchida Y, Uno T, Ohta S, Homma T, Yamaguchi F, Suzuki S, Sagara H. Prevalence and Impact of Social Frailty in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:2117-2126. [PMID: 37780032 PMCID: PMC10541088 DOI: 10.2147/copd.s418071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/17/2023] [Indexed: 10/03/2023] Open
Abstract
Background Patients with chronic obstructive pulmonary disease (COPD) are more inclined to have a high level of social vulnerability due to their physical and psychological burden. However, to date, there have been no study on social frailty in patients with COPD. This study aimed to investigate the prevalence, characteristics, and impact of social frailty in patients with COPD. Methods Social frailty was assessed using five items in a questionnaire. A patient was diagnosed with social frailty if responses to two or more items were positive. Four hundred and five patients with COPD were assessed for social frailty, dyspnea, and appetite. We also prospectively examined the number of acute exacerbation and unexpected hospitalization for 1 year. Results Thirty-six percent of patients with COPD had social frailty. They had reduced appetite and more severe dyspnea [Simplified Nutritional Appetite Questionnaire score: odds ratio (OR) 0.81, 95% confidence interval (CI) 0.69‒0.95, p < 0.01; modified Medical Research Council score: OR 1.42, 95% CI 1.05‒1.93, P = 0.02] than patients without social frailty. Social frailty was not a risk factor for moderate acute exacerbation of COPD but a risk factor for severe acute exacerbation and all-cause unexpected hospitalization (severe acute exacerbation: β, standardized regression coefficient: 0.13, 95% CI 0.01‒0.25, P = 0.04, unexpected hospitalization: β 0.17, 95% CI 0.05‒0.29, P = 0.01). Conclusion The prevalence of social frailty is 36%; however, social frailty has a marked clinical impact in patients with COPD.
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Affiliation(s)
- Kuniaki Hirai
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Tanaka
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Naruhito Oda
- Department of Medicine, Division of Respiratory Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan
| | - Keisuke Kaneko
- Department of Medicine, Division of Respiratory Medicine, Tokyo Metropolitan Health and Hospitals Corporation Ebara Hospital, Tokyo, Japan
| | - Yoshitaka Uchida
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Uno
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Homma
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Fumihiro Yamaguchi
- Department of Medicine, Division of Respiratory Medicine, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Shintaro Suzuki
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
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22
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MacLeod A, Levesque J, Ward-Griffin C. Social Isolation of Older Adults, Family, and Formal Caregivers During the COVID-19 Pandemic: Stories and Solutions Through Participatory Action Research. Can J Aging 2023:1-14. [PMID: 37721044 DOI: 10.1017/s071498082300048x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
This participatory action research (PAR) aimed to understand the health implications of guidelines impacting social isolation among frail community-dwelling older adults and their family and formal caregivers during the coronavirus disease (COVID-19) pandemic. Reflexive thematic analysis (RTA) of data collected from 10 policy/procedural documents revealed four themes: valuing principles, identifying problem(s), setting priorities, and making recommendations. Interviews with 31 participants from Peterborough, Ontario, also revealed four themes: sacrificing social health, diminishing physical health, draining mental health, and defining supports. Recommendations to decision makers were finalized at a knowledge exchange event involving participants and members of Age-friendly Peterborough. Key findings demonstrate the need for Canadian governments and health and social service agencies to enhance access to technology-based interventions, and educational and financial resources for caregivers. Meaningful communication and collaboration between older adults, caregivers, and decision makers are also needed to reduce the gap between policy and practice when addressing social isolation.
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Affiliation(s)
- Ann MacLeod
- Trent/Fleming School of Nursing, Peterborough, ON, Canada
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23
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Rauzi MR, Abbate LM, Lum HD, Cook PF, Stevens-Lapsley JE. Multicomponent telerehabilitation programme for older veterans with multimorbidity: a programme evaluation. BMJ Mil Health 2023:e002535. [PMID: 37709508 PMCID: PMC10937321 DOI: 10.1136/military-2023-002535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Older veterans with multimorbidity experience physical, mental and social factors which may negatively impact health and healthcare access. Physical function, behaviour change skills and loneliness may not be addressed during traditional physical rehabilitation. Thus, a multicomponent telerehabilitation programme could address these unmet needs. This programme evaluation assessed the safety, feasibility and change in patient outcomes for a multicomponent telerehabilitation programme. METHODS Individuals were eligible if they were a veteran/spouse, age ≥50 years and had ≥3 comorbidities. The telerehabilitation programme included four core components: (1) High-intensity rehabilitation, (2) Coaching interventions, (3) Social support and (4) Technology. Physical therapists delivered the 12-week programme and collected patient outcomes at baseline, 4 weeks, 8 weeks and 12 weeks. Programme evaluation measures included safety events (occurrence and type), feasibility (adherence) and patient outcomes (physical function). Safety and feasibility outcomes were analysed using descriptive statistics. The mean pre-post programme difference and 95% CI for patient outcomes were generated using paired t-tests. RESULTS Twenty-one participants enrolled in the telerehabilitation programme; most were male (81%), white (72%) and non-Hispanic (76%), with an average of 5.7 (3.0) comorbidities. Prevalence of insession safety events was 3.2% (0.03 events/session). Fifteen (71.4%) participants adhered to the programme (attended ≥80% of sessions). Mean (95% CI) improvements for physical function are as follows: 4.7 (2.4 to 7.0) repetitions for 30 s sit to stand, 6.0 (4.0 to 9.0) and 5.0 (2.0 to 9.0) repetitions for right arm curl and left arm curl, respectively, and 31.8 (15.9 to 47.7) repetitions for the 2 min step test. CONCLUSION The telerehabilitation programme was safe, feasible and demonstrated preprogramme to postprogramme improvements in physical function measures while addressing unmet needs in a vulnerable population. These results support a randomised clinical trial while informing programme and process adaptations.
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Affiliation(s)
- Michelle R Rauzi
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - L M Abbate
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, Colorado, USA
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
| | - H D Lum
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - P F Cook
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - J E Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, Colorado, USA
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Chou YH, Lin C, Lee SH, Chang Chien YW, Cheng LC. Potential Mobile Health Applications for Improving the Mental Health of the Elderly: A Systematic Review. Clin Interv Aging 2023; 18:1523-1534. [PMID: 37727447 PMCID: PMC10506600 DOI: 10.2147/cia.s410396] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023] Open
Abstract
The rapid aging of the global population presents challenges in providing mental health care resources for older adults aged 65 and above. The COVID-19 pandemic has further exacerbated the global population's psychological distress due to social isolation and distancing. Thus, there is an urgent need to update scholarly knowledge on the effectiveness of mHealth applications to improve older people's mental health. This systematic review summarizes recent literature on chatbots aimed at enhancing mental health and well-being. Sixteen papers describing six apps or prototypes were reviewed, indicating the practicality, feasibility, and acceptance of chatbots for promoting mental health in older adults. Engaging with chatbots led to improvements in well-being and stress reduction, as well as a decrement in depressive symptoms. Mobile health applications addressing these studies are categorized for reference.
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Affiliation(s)
- Ya-Hsin Chou
- Department of Psychiatry, Taoyuan Chang Gung Memorial Hospital, Taoyuan County, Taiwan
| | - Chemin Lin
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shwu-Hua Lee
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan
- Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan County, Taiwan
| | - Ya-Wen Chang Chien
- Department of Photography and Virtual Reality Design, Huafan University, New Taipei, Taiwan
| | - Li-Chen Cheng
- Department of Information and Finance Management, National Taipei University of Technology, Taipei, Taiwan
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25
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Smith ML, Chen E, Lau CA, Davis D, Simmons JW, Merianos AL. Effectiveness of chronic disease self-management education (CDSME) programs to reduce loneliness. Chronic Illn 2023; 19:646-664. [PMID: 35957597 DOI: 10.1177/17423953221113604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES With about half of older adults reporting feelings of loneliness, interventions are needed to improve connectedness among our aging population. The health benefits of Chronic Disease Self-Management Education (CDSME) programs are well documented, but workshops' ability to reduce loneliness remains unknown. METHODS Using the Campaign to End Loneliness Measurement Tool, we examined 295 CDSME participants' loneliness changes before and after the 6-week face-to-face workshops. Statistical analyzes used generalized estimating equations (GEE). RESULTS On average, participants were age 74.3(±8.9) years and self-reported 3.3(±2.2) chronic conditions. The majority of participants were female (83%) and attended workshops in English (77%). Significant reductions in loneliness scores were observed from baseline to post-workshop (p < 0.001). DISCUSSION Findings expand our understanding about the benefits of small-group CDSME workshops to reduce loneliness among participants. CDSME workshops may reduce loneliness because of their highly interactive and process-driven format and ability to create bonds between participants with chronic conditions and shared experiences.
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Affiliation(s)
- Matthew Lee Smith
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Population Health and Aging, Texas A&M University, College Station, TX, USA
| | | | | | - Dianne Davis
- Partners in Care Foundation, San Fernando, CA, USA
| | | | - Ashley L Merianos
- Center for Population Health and Aging, Texas A&M University, College Station, TX, USA
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
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Welch V, Tanjong Ghogomu E, Dowling S, Choo WY, Yunus RM, Mohd TAMT, Haitas N, Bomze S, Dahrouge S, Garcia E, Holt‐Lunstad J, Lasgaard M, Lim MH, Mulligan K, Salzwedel DM, Qualter P, Hébert PC, Mikton C. PROTOCOL: In-person interventions to reduce social isolation and loneliness: An evidence and gap map. Campbell Syst Rev 2023; 19:e1340. [PMID: 37361556 PMCID: PMC10286723 DOI: 10.1002/cl2.1340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
This is the protocol for an evidence and gap map. The objectives are as follows: This EGM aims to map available evidence on the effects of in-person interventions to reduce social isolation and/or loneliness across all age groups in all settings.
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Affiliation(s)
| | | | | | - Wan Yuen Choo
- Department of Social & Preventive Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Raudah M. Yunus
- Public Health MedicineUniversiti Teknologi MARASungai BulohMalaysia
| | | | | | - Sivan Bomze
- Canadian Red CrossMississaugaCanada
- Canadian Red CrossMississaugaCanada
| | | | - Edward Garcia
- Foundation for Social ConnectionWashingtonDistrict of ColumbiaUSA
| | | | - Mathias Lasgaard
- DEFACTUM ‐ Public Health and Health Services ResearchCentral Denmark RegionAarhus NDenmark
| | - Michelle H. Lim
- University of Sydney, School of Public HealthSydneyAustralia
- Ending Loneliness TogetherMelbourneAustralia
| | - Kate Mulligan
- University of Toronto, Dalla Lana School of Public HealthTorontoCanada
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverCanada
| | - Pamela Qualter
- University of Manchester, Mancehster Institute of EducationManchesterUK
| | - Paul C. Hébert
- Bruyere Research InstitutePalliative Care University of OttawaOttawaCanada
| | - Christopher Mikton
- World Health Organization, Department of Social Determinants of HealthGenevaSwitzerland
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27
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Steiner-Lim GZ, Karamacoska D, Abramov G, Dubois S, Harley A, McDonald K, Hohenberg MI. "I'm On My Own, I Need Support": Needs Assessment of Community Aged Care Services. Int J Integr Care 2023; 23:14. [PMID: 37745199 PMCID: PMC10516138 DOI: 10.5334/ijic.7005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/12/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Well-integrated community aged care services empower and enable older people to live and thrive in the community by supporting activities of daily living. To inform integrated community aged care service planning and delivery in South Western Sydney Australia, a needs assessment with consumers (i.e., older people), their caregivers, and healthcare providers was conducted. This study details the comprehensive and inclusive needs assessment process undertaken, with a focus on translating the findings into practice to improve integrated care. Description Qualitative interviews and community forum-style focus groups engaged 160 stakeholders including GPs, older people, and aged care workers. Transcribed data were thematically coded using an inductive approach. Data were organised into four themes: 1) access to community aged care services; (2) healthcare and medical needs; (3) social concerns and needs; and (4) education and information needs. Discussion The needs assessment undertaken identified unmet needs, gaps in service provision, and recommendations for improving integrated community aged care services. Conclusion Findings are novel in the context of South Western Sydney, Australia. The study design, methods employed, and lessons learned can be adapted internationally for future needs assessments to inform policy, strategies, and integrated aged care service delivery.
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Affiliation(s)
- Genevieve Z. Steiner-Lim
- NICM Health Research Institute and Translational Health Research Institute (THRI), Western Sydney University, Penrith NSW 2751, AU
| | - Diana Karamacoska
- NICM Health Research Institute and Translational Health Research Institute (THRI), Western Sydney University, Penrith NSW 2751, AU
| | - Gamze Abramov
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, AU
- School of Psychology, University of Wollongong, Wollongong NSW 2522, AU
| | - Shamieka Dubois
- NICM Health Research Institute and Translational Health Research Institute (THRI), Western Sydney University, Penrith NSW 2751, AU
| | - Anne Harley
- South Western Sydney Primary Health Network, Campbelltown NSW 2560, AU
| | - Keith McDonald
- South Western Sydney Primary Health Network, Campbelltown NSW 2560, AU
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Guarnera J, Yuen E, Macpherson H. The Impact of Loneliness and Social Isolation on Cognitive Aging: A Narrative Review. J Alzheimers Dis Rep 2023; 7:699-714. [PMID: 37483321 PMCID: PMC10357115 DOI: 10.3233/adr-230011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/28/2023] [Indexed: 07/25/2023] Open
Abstract
Social concepts such as loneliness and social isolation are fairly new factors that have been recently gaining attention as to their involvement in changes in cognitive function and association with dementia. The primary aim of this narrative review was to describe the current understanding of how loneliness and social isolation influence cognitive aging and how they are linked to dementia. Studies have shown that there is an association between loneliness, social isolation, and reduced cognitive function, in older adults, across multiple cognitive domains, as well as a heightened risk of dementia. Numerous changes to underlying neural biomechanisms including cortisol secretion and brain volume alterations (e.g., white/grey matter, hippocampus) may contribute to these relationships. However, due to poor quality research, mixed and inconclusive findings, and issues accurately defining and measuring loneliness and social isolation, more consistent high-quality interventions are needed to determine whether studies addressing loneliness and social isolation can impact longer term risk of dementia. This is especially important given the long-term impact of the COVID-19 pandemic on social isolation in older people is yet to be fully understood.
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Affiliation(s)
- Jade Guarnera
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Eva Yuen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, VIC, Australia
- Centre for Quality and Patient Safety-Monash Health Partnership, Institute for Health Transformation, Deakin University, Melbourne, VIC, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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29
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Steijvers LCJ, Leeferink F, Brinkhues S, Hoebe CJPA, Dukers-Muijrers NHTM. Social networks and health behaviors during the COVID-19 pandemic: a qualitative study among older adults in the Netherlands. Z Gesundh Wiss 2023:1-12. [PMID: 37361294 PMCID: PMC10248984 DOI: 10.1007/s10389-023-01947-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023]
Abstract
Aim Social networks, all social relationships that people have, may influence people's health behavior and well-being, which was evaluated in this qualitative study in older adults. Furthermore, we evaluated people's needs for strengthening social networks. Subject and methods For this qualitative study, semi-structured interviews were conducted between May and July 2021 among 24 adults aged 60 years and older. Results Respondents provided information on social network structure (number and types of relations) and function (social support). They received informational support from friends, emotional support from their partner/spouse, and all types of support (including practical support) from family. Respondents stated that their health behavior was mainly influenced by a partner/spouse. Family and friends were mostly for socializing. To strengthen networks, in-person bilateral or small group interactions were preferred. Conclusion Family and friends were important social supporters and positively influenced health behaviors. This study emphasizes the importance of social networks in health promotion.
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Affiliation(s)
- Lisanne C. J. Steijvers
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
| | - Floor Leeferink
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
| | - Stephanie Brinkhues
- Department of Knowledge and Innovation, South Limburg Public Health Service, Heerlen, the Netherlands
| | - Christian J. P. A. Hoebe
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Nicole H. T. M. Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Perkins R, Spiro N, Waddell G. Online songwriting reduces loneliness and postnatal depression and enhances social connectedness in women with young babies: randomised controlled trial. Public Health 2023; 220:72-79. [PMID: 37270855 DOI: 10.1016/j.puhe.2023.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/12/2023] [Accepted: 04/21/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Loneliness is a public health challenge associated with postnatal depression (PND). This study developed and tested an online songwriting intervention, with the aim of reducing loneliness and symptoms of PND and enhancing social connectedness among women with young babies. STUDY DESIGN This was a two-armed non-blinded randomised controlled trial (RCT, ISRCTN17647261). METHODS Randomisation was conducted in Excel using a 1:1 allocation, with participants (N = 89) allocated to an online 6-week songwriting intervention (Songs from Home) or to waitlist control. Inclusion criteria were women aged ≥18 years, with a baby ≤9 months old, reporting loneliness (4+ on UCLA 3-Item Loneliness Scale) and symptoms of PND (10+ on Edinburgh Postnatal Depression Scale [EPDS]). Loneliness (UCLA-3) was measured at baseline, after each intervention session and at 4-week follow-up. The secondary measures of PND (EPDS) and social connectedness (Social Connectedness Revised 15-item Scale [SC-15]) were measured at baseline, postintervention and at 4-week follow-up (Week 10). Factorial mixed analyses of variance with planned custom contrasts were conducted for each outcome variable comparing the intervention and control groups over time and across baseline, Weeks 1-6 and the follow-up at Week 10 for each outcome variable. RESULTS Compared with waitlist control, the intervention group reported significantly lower scores postintervention and at follow-up for loneliness (P < 0.001, η2P = 0.098) and PND (P < 0.001, η2P = 0.174) and significantly higher scores at follow-up for social connectedness (P < 0.001, η2P = 0.173). CONCLUSIONS A 6-week online songwriting intervention for women with young babies can reduce loneliness and symptoms of PND and increase social connectedness.
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Affiliation(s)
- R Perkins
- Centre for Performance Science, Royal College of Music, Prince Consort Road, London SW7 2BS, UK; Faculty of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
| | - N Spiro
- Centre for Performance Science, Royal College of Music, Prince Consort Road, London SW7 2BS, UK; Faculty of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - G Waddell
- Centre for Performance Science, Royal College of Music, Prince Consort Road, London SW7 2BS, UK; Faculty of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
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Paquet C, Whitehead J, Shah R, Adams AM, Dooley D, Spreng RN, Aunio AL, Dubé L. Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources. J Med Internet Res 2023; 25:e40213. [PMID: 37195738 PMCID: PMC10233446 DOI: 10.2196/40213] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community. OBJECTIVE This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults. METHODS A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources. RESULTS The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services. CONCLUSIONS A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.
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Affiliation(s)
- Catherine Paquet
- Département de Marketing, Faculté des Sciences de l'Administration, Université Laval, Québec, QC, Canada
- Centre de Recherche, Centre Hospitalier Universitaire de Québec - Université Laval, Quebec, QC, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Quebec, QC, Canada
| | - Jocelyne Whitehead
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Rishabh Shah
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Alayne Mary Adams
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Damion Dooley
- Centre for Infectious Disease Genomics and One Health, Simon Fraser University, Vancouver, BC, Canada
| | - R Nathan Spreng
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | | | - Laurette Dubé
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
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Hussain B, Mirza M, Baines R, Burns L, Stevens S, Asthana S, Chatterjee A. Loneliness and social networks of older adults in rural communities: a narrative synthesis systematic review. Front Public Health 2023; 11:1113864. [PMID: 37255758 PMCID: PMC10225733 DOI: 10.3389/fpubh.2023.1113864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Loneliness has significant impacts on the health of older adults. Social networks help to improve psychosocial and quality of life outcomes among older adults. A fifth of older adults live in rural communities, where geographic isolation poses challenges to health. The dynamics of social networks of older adults in rural communities has not been explored. Objective To synthesize the literature related to loneliness and social networks of older adults in rural settings. Methods A mixed-methods systematic review was conducted through searching six bibliographic databases to retrieve peer-reviewed literature with no time limits. We performed a methodological assessment of each study using a mixed method quality assessment tool. Findings are synthesized thematically. Results A total of 50 studies (32 quantitative, 15 qualitative, and 3 mixed methods) were included in this review. Studies were conducted in 17 different countries, the majority from China (n = 12), the UK (n = 9), and USA (n = 9). Findings revealed that social networks of older adults consist of family, friends and neighbors and continue to be developed through participation in various physical and social activities such as walking groups and participation in religious events. Social networks offer informational, functional, psychological and social support to older adults. Through their social networks, older adults feel socially connected and cared for. Successful interventions to improve social networks and address loneliness were those developed in groups or one-on-one with the older adults. The key ingredient to the positive impact of these interventions on reducing social isolation and loneliness was the formation of a social connection and regular engagement with the older adults. However, the review did not find any explicitly reported theory or model on which these interventions are based. Conclusion The prevalence of loneliness among older adults in rural areas needs urgent attention. Social network theory and methods can help in developing interventions to address social isolation and loneliness among older adults in rural communities.
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Affiliation(s)
- Basharat Hussain
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Mahrukh Mirza
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Rebecca Baines
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Lorna Burns
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | | | - Sheena Asthana
- Plymouth Institute of Health and Care Research (PIHR), Plymouth, United Kingdom
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Centre for Coastal Communities, University of Plymouth, Plymouth, United Kingdom
| | - Arunangsu Chatterjee
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- School of Medicine, University of Leeds, Leeds, United Kingdom
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Li S, Milligan K, Blythe P, Zhang Y, Edwards S, Palmarini N, Corner L, Ji Y, Zhang F, Namdeo A. Exploring the role of human-following robots in supporting the mobility and wellbeing of older people. Sci Rep 2023; 13:6512. [PMID: 37081106 PMCID: PMC10119299 DOI: 10.1038/s41598-023-33837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/19/2023] [Indexed: 04/22/2023] Open
Abstract
With the ever-pressing challenges of societal ageing, robotic technologies for older people are increasingly portrayed as a solution for better independent living for longer. However, the application of human-following robots for elderly citizens has not yet been considered, and any prospective benefits offered by the technology for active ageing have previously been overlooked. This qualitative research aimed to explore older people's needs and requirements towards the human-following robot through the reflexive thematic analysis of semi-structured interview data from 17 independent older adults, supported by a video-based demonstration of the robot. The results indicate that older people believed that human-following robot has the potential to provide social benefits to an independent older adult by encouraging walking trips and prompting social interaction with others in the community. Practical limitations and cost of the robot are barriers to adoption at present. The findings indicate that there is potential for human-following robots to support active ageing, through increasing opportunities for the social participation of an older adult, but further development of the robot is needed for this potential to be realised.
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Affiliation(s)
- Shuo Li
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK.
| | - Kirsty Milligan
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK
| | - Phil Blythe
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK
| | - Yanghanzi Zhang
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK
| | - Simon Edwards
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK
| | - Nic Palmarini
- UK's National Innovation Centre for Ageing, The Catalyst, 3 Science Square, Newcastle Upon Tyne, NE4 5TG, UK
| | - Lynne Corner
- UK's National Innovation Centre for Ageing, The Catalyst, 3 Science Square, Newcastle Upon Tyne, NE4 5TG, UK
| | - Yanjie Ji
- Jiangsu Key Laboratory of Urban ITS, Jiangsu Province Collaborative Innovation Centre of Modern Urban Traffic Technologies, School of Transportation, Southeast University, Southeast University Road 2, Nanjing, 211189, China
| | - Fan Zhang
- Jiangsu Key Laboratory of Urban ITS, Jiangsu Province Collaborative Innovation Centre of Modern Urban Traffic Technologies, School of Transportation, Southeast University, Southeast University Road 2, Nanjing, 211189, China
| | - Anil Namdeo
- Department of Geography and Environmental Sciences, Northumbria University, Ellison Place, Newcastle Upon Tyne, NE1 8ST, UK
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Umoh ME, Prichett L, Boyd CM, Cudjoe TKM. Impact of technology on social isolation: Longitudinal analysis from the National Health Aging Trends Study. J Am Geriatr Soc 2023; 71:1117-1123. [PMID: 36519748 PMCID: PMC10089961 DOI: 10.1111/jgs.18179] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/12/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Social isolation is a key public health concern and has been associated with numerous negative health consequences. Technology is increasingly thought of as a solution to address social isolation. This study examines the longitudinal association between the access and use of technology and social isolation in older adults 65 and older, living in the United States. METHODS This observational cohort study included community-dwelling older adults (N = 6704) who participated in the National Health and Aging Trends Study. Regression analyses were conducted using data from 2015 to 2019. Information about technology access and use was ascertained using self-reported questionnaires. The primary outcome was the risk of social isolation. RESULTS At baseline, the majority of older adults that were not socially isolated had a working cell phone (88%) or computer (71%) and used email or text messaging (56%). Older adults that had access to (cell phone- incidence rate ratio [IRR] 0.62 [95% CI 0.48-0.81]; computer- IRR 0.63 [95% CI 0.51-0.78]), and used technology (email or text messaging- IRR 0.64 [95% CI 0.51-0.80]) in the year prior had a lower risk of social isolation than older adults who reported they did not access or use technology. Additionally, over four years, older adults who reported that they had access to a computer had a lower risk (0.69 [0.57, 0.84]) for social isolation than their counterparts. CONCLUSION In this cohort study, technology access was associated with a lower risk for social isolation among community-dwelling older adults. These findings suggest that technology has an important role in approaches that seek to prevent social isolation among older adults.
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Affiliation(s)
- Mfon E Umoh
- Department of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Laura Prichett
- Johns Hopkins University, Biostatistics, Epidemiology And Data Management (BEAD) Core, Baltimore, Maryland, USA
| | - Cynthia M Boyd
- Department of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Thomas K M Cudjoe
- Department of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Ashikali EM, Ludwig C, Mastromauro L, Périvier S, Tholomier A, Ionita I, Graf C, Busnel C. Intrinsic Capacities, Functional Ability, Physiological Systems, and Caregiver Support: A Targeted Synthesis of Effective Interventions and International Recommendations for Older Adults. Int J Environ Res Public Health 2023; 20:4382. [PMID: 36901392 PMCID: PMC10002353 DOI: 10.3390/ijerph20054382] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
The ageing population calls for interventions that can assist older people to age healthily. This study aimed to provide a targeted synthesis of high-level research and current evidence-based recommendations on effective interventions for maintaining or preventing the decline in intrinsic capacity, functional ability, and physiological systems, or for caregiver support. Nestled within the healthy ageing framework by the World Health Organization, available evidence was selected in a targeted manner, with the purpose of providing a synthesis that would allow the application of this knowledge in real life. As such, the outcome variables were examined through an Evidence and Gap Map of interventions for functional ability and through guidelines from leading institutions. Systematic reviews, meta-analyses, and guidelines on community-dwelling older adults with or without minor health limitations were considered. Thirty-eight documents were included and over fifty interventions identified. Physical activity interventions were consistently effective across several domains. Recommendations point to screening, whilst highlighting the importance of behavioural factors in the endeavour to age healthily. There is a wide range of activities which are likely to foster healthy ageing. To encourage their uptake, it is important for communities to offer suitable promotion and support, and to make these accessible to the public.
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Affiliation(s)
| | - Catherine Ludwig
- Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, 1206 Geneva, Switzerland
| | - Laura Mastromauro
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
- Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, 1206 Geneva, Switzerland
| | - Samuel Périvier
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, 1226 Geneva, Switzerland
| | - Aude Tholomier
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
| | - Irina Ionita
- PLATEFORME du Réseau Seniors Genève, 1227 Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, 1226 Geneva, Switzerland
| | - Catherine Busnel
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
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Murphy GL, Beridze G, Vetrano DL, Calderón-Larrañaga A. Social network and severe lower respiratory tract infections in older adults: findings from a Swedish longitudinal population-based study. Int J Infect Dis 2023; 128:176-183. [PMID: 36587838 DOI: 10.1016/j.ijid.2022.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/07/2022] [Accepted: 12/25/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To investigate the association between social network and the risk and prognosis of severe lower respiratory tract infections (LRTIs) in older adults. METHODS Data from Swedish hospital records were matched with the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Social network was operationalized as social connections and social support, based on different self-reported variables, and categorized as low, medium, and high. The risk of severe LRTI and related outcomes were assessed using Cox, Poisson, and logistic regression models where appropriate. RESULTS A total of 362 individuals experienced LRTI-related hospitalizations between 2001 and 2016 (479 total hospitalizations). High levels of social support decreased the hazard of incident LRTI by 29% (hazard ratio 0.71, 95% confidence interval [CI] 0.52-0.96), the hospital length of stay by 21% (incidence rate ratio 0.79, 95% CI 0.65-0.97), and the risk of 30-day mortality by 92% (odds ratio 0.08, 95% CI 0.01-0.68), but was a risk factor for 30-day readmission (odds ratio 3.16, 95% CI 1.38-7.24). High levels of social connections were associated with a higher risk of incident LRTI in women and those with dementia and/or slow walking speed (Pinteraction <0.05). CONCLUSION Older individuals' quality of social support seems to be a stronger determinant of LRTI incidence and prognosis than the quantity of their social connections. These findings may inform evidence-based policies aimed at preventing LRTIs in older adults.
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Affiliation(s)
- Gillian L Murphy
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
| | - Giorgi Beridze
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
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Blakø M, Christensen AV, Højskov IE, Palm P, Berg SK. Protocol for a feasibility randomized trial of a social support intervention plus usual care versus usual care, targeting patients treated for cardiac disease who experience loneliness. Pilot Feasibility Stud 2023; 9:22. [PMID: 36747245 PMCID: PMC9900972 DOI: 10.1186/s40814-023-01255-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/28/2023] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION In patients treated for cardiac disease, loneliness is known to contribute negatively to health behavior, health outcome, and increase risk of cardiac and all-cause mortality. Even so, in health care research, social support interventional studies targeting patients who experience loneliness are lacking. AIM To determine the feasibility of an individually structured social support intervention targeting patients treated for cardiac disease who experience loneliness. DESIGN A feasibility study based on randomized clinical trial design with 1:1 randomization to a 6-month social support program, plus usual care (intervention) versus usual care, (i.e., regular guidelines-based follow-up). INTERVENTION Patients classified as high risk lonely according to the High Risk Loneliness tool will be provided with an informal caregiver in the 6 months rehabilitation phase following cardiac disease treatment. The informal caregiver will be designated by the patient from the existing social network or a peer, depending on patients' preferences. The core content of the intervention is through nurse consultations at baseline and 1, 3, and 6 months, to enhance and reinforce the informal caregiver's competences to be a social support resource. The theoretical framework of the nurse consultations will be based on middle-range theory of self-care. OUTCOME Feasibility will be evaluated in terms of acceptability and adherence according to predefined feasibility criteria. The preliminary effect of the intervention on patient-reported outcomes, health behaviors, and health outcomes will be evaluated in the intervention and the control group at baseline and 1, 3, 6, and 12 months. DISCUSSION The present study will contribute with knowledge on how to implement a feasible social support intervention targeting patients treated for cardiac disease who experience loneliness and, furthermore, investigate the preliminary effect on health behavior and health outcome in the early rehabilitation period. TRIAL REGISTRATION The trial is registered on clinicaltrials.gov (NCT05503810) 18.08.2022.
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Affiliation(s)
- Mitti Blakø
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Anne Vinggaard Christensen
- grid.4973.90000 0004 0646 7373Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Ida Elisabeth Højskov
- grid.4973.90000 0004 0646 7373Department of Heart- and Lung Surgery, RT, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Pernille Palm
- grid.4973.90000 0004 0646 7373Department of Cardiology B, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Selina Kikkenborg Berg
- grid.4973.90000 0004 0646 7373Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XFaculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, N 2200 Copenhagen, Denmark
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Li J, Zhou X, Wang Q. Interventions to reduce loneliness among Chinese older adults: A network meta-analysis of randomized controlled trials and quasi-experimental studies. Appl Psychol Health Well Being 2023; 15:238-258. [PMID: 35621111 DOI: 10.1111/aphw.12375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 05/03/2022] [Accepted: 05/14/2022] [Indexed: 01/26/2023]
Abstract
This meta-analytic study investigates the effectiveness of different interventions in alleviating loneliness among Chinese older adults aged 50 years and above. We searched eight English databases, four Chinese databases, and grey literature. Thirty-four studies, including four randomized controlled trials (RCTs) and 30 quasi-experimental studies, were eventually included in the meta-analysis (n = 3843). Quality appraisal indicated risks of bias in the included studies. The pooled effect size was large and significant (Hedge's g = 0.84, 95% CI [0.54, 1.15]), indicating the effectiveness of interventions in reducing loneliness. However, the effect size may be overestimated due to publication bias. Moderation analyses showed significant differences in effect sizes by study designs and regions of studies. Network meta-analysis (NMA) indicated that hybrid and psychological interventions appeared to be advantageous over others. In addition, group-based delivery modes can add extra benefits to the interventions. This study adds to the knowledge of the effectiveness of current interventions in reducing Chinese older people's loneliness. However, the findings need to be interpreted with caution due to the relatively low study quality, considerable heterogeneity, and publication bias. Despite the limitations, this study offers valuable insights for future research, practice, and policy-making in reducing older people's loneliness.
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Affiliation(s)
- Jia Li
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaochen Zhou
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Qi Wang
- College of Philosophy, Law & Political Science, Shanghai Normal University, Shanghai, China
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Gusdal AK, Florin U, Johansson-Pajala RM, Eklund C, Fritz J, von Heideken Wågert P. Older Adults' Use of a Research-Based Web Platform for Social Interaction. Healthcare (Basel) 2023; 11. [PMID: 36766983 DOI: 10.3390/healthcare11030408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/24/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Loneliness and social isolation are triggers for unfavorable changes in older adults' health and well-being. Information and communication technology (ICT) can be used by older adults to mitigate the negative effects of loneliness and social isolation. However, ICT needs to be customized to the specific needs and conditions of older adults. The aim of this study was to explore older adults' use of a new, co-designed and research-based web platform for social interaction from the perspectives of older adults, researchers, and social services personnel. The study is an intervention study with a multimethod approach in which 20 older adults used the web platform for social interaction "the Fik@ room" for eight weeks. Quantitative and qualitative data were collected pretest, during the test, and posttest. The Fik@ room met the expectations of those older adults who completed the study. It enabled them to expand their social network and develop new friendships, but their experiences of loneliness were not reduced. The involvement of social services personnel in recruitment and support was important in facilitating older adults' use of the Fik@ room. Our study contributes knowledge about a new, co-designed and research-based web platform, customized specifically for older adults, which is valuable in guiding the design and delivery of future web platforms for social interaction among older adults.
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Garnett A, Prentice K, Booth R, Donelle L, Orange JB, Webster F. Social Isolation in Community-Dwelling Older Adults During COVID-19: Understanding the Role of Resilience. Inquiry 2023; 60:469580221148880. [PMID: 36680364 PMCID: PMC9871445 DOI: 10.1177/00469580221148880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The COVID-19 pandemic increased social isolation for many older adults, causing concern for their health and well-being. To enhance understanding of how community-dwelling older adults were impacted by prolonged social isolation during COVID-19, a qualitative descriptive study was conducted to: (1) explore the self-reported factors supporting their resilience during COVID-19 related social isolation, and (2) to help understand the intentional and unintentional outcomes of the government mandated health measures. A total of 19 community dwelling older adults were sampled. Factors that supported older adults' resilience during COVID-19 included maintaining positivity, drawing on historical experiences of resilience and finding opportunities to connect with their community. However, collective safety came with losses: such as time, freedom, opportunity, engagement, and initiative. The findings provide insight on contributing factors to resilience against social isolation in older adults and suggest the value of collective, community-based approaches to build resilience across variable contexts in this population.
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Affiliation(s)
- A. Garnett
- Western University, London, ON,
Canada,Anna Garnett, Arthur Labatt Family School
of Nursing, Western University, FIMS & Nursing Building, Rm 2306, London, ON
N6A 5B9 Canada.
| | | | - R. Booth
- Western University, London, ON,
Canada
| | - L. Donelle
- University of South Carolina, Columbia,
SC, USA
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41
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Finnegan DJ, Campbell S. Tackling Loneliness and Isolation in Older Adults With Virtual Reality: How do We Move Forward? Gerontol Geriatr Med 2023; 9:23337214231186204. [PMID: 37465186 PMCID: PMC10350751 DOI: 10.1177/23337214231186204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/30/2023] [Accepted: 06/15/2023] [Indexed: 07/20/2023] Open
Abstract
Current trends in gerontology conceptualize Virtual Reality (VR) as a tool for rehabilitation, lauding its potential for cognitive rehabilitation or as an intervention to reduce cognitive function decline. However, we must take a critical stance and identify not just the potential positive impact, but also how things may go wrong without appropriate guidelines, and the need for careful design around the interaction affordances of the technology. We conducted co-discovery and co-design workshops involving expert stakeholders and older adults (N = 25) over a period of 6 months, involving practical activities including user personas and focus groups to understand the complexities of loneliness and identify possible solutions with VR. Based on our findings we focus our argument on two key factors in the conceptualization of loneliness: spaces, and activities which may take place within said spaces. We present our reconceptualization of VR as a tool for group activities instead of passive consumption of content and make suggestions to the community for reducing feelings of loneliness with VR.
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Madani MT, Madani L, Ghogomu ET, Dahrouge S, Hébert PC, Juando-Prats C, Mulligan K, Welch V. Is equity considered in systematic reviews of interventions for mitigating social isolation and loneliness in older adults? BMC Public Health 2022; 22:2241. [PMID: 36456997 PMCID: PMC9713122 DOI: 10.1186/s12889-022-14667-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Social isolation and loneliness affect one in four older adults in many regions around the world. Social isolation and loneliness are shown to be associated with declines in physical and mental health. Intersecting social determinants of health influence both the risk of being socially isolated and lonely as well as the access and uptake of interventions. Our objective is to evaluate what evidence is available within systematic reviews on how to mitigate inequities in access to and effectiveness of interventions. METHODS We performed an overview of reviews following methods of the Cochrane Handbook for Overviews of Reviews. We selected systematic reviews of effectiveness of interventions aimed at mitigating social isolation and loneliness in older adults (aged 60 or above) published in the last 10 years. In addition, we assessed all primary studies from the most recent systematic review with a broad intervention focus. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus in collaboration with a librarian scientist. We used a structured framework called PROGRESS-Plus to assess the reporting and consideration of equity. PROGRESS-Plus stands for place of residence, race/ethnicity/culture/language, occupation, gender or sex, religion, education, socioeconomic status (SES), social capital, while "plus" stands for additional factors associated with discrimination and exclusion such as age, disability, and sexual orientation. We assessed whether PROGRESS-Plus factors were reported in description of the population, examination of differential effects, or discussion of applicability or limitations. RESULTS We identified and assessed 17 eligible systematic reviews. We assessed all 23 primary studies from the most recent systematic review with a broad intervention focus. All systematic reviews and primary studies described the population by one or more PROGRESS-Plus factor, most commonly across place of residence and age, respectively. None of the reviews and five primary studies examined differential effects across one or more PROGRESS-Plus dimension. Nine reviews and four primary studies discussed applicability or limitations of their findings by at least one PROGRESS-Plus factor. CONCLUSIONS Although we know that social isolation and loneliness are worse for the poorest and most socially disadvantaged older adults, the existing evidence base lacks details on how to tailor interventions for these socially disadvantaged older people.
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Affiliation(s)
- Mohamad Tarek Madani
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Leen Madani
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Elizabeth Tanjong Ghogomu
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Simone Dahrouge
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Paul C. Hébert
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Clara Juando-Prats
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON Canada
| | - Kate Mulligan
- grid.17063.330000 0001 2157 2938Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Vivian Welch
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
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Kotwal AA, Batio S, Wolf MS, Covinsky KE, Yoshino Benavente J, Perissinotto CM, O'Conor RM. Persistent loneliness due to COVID-19 over 18 months of the pandemic: A prospective cohort study. J Am Geriatr Soc 2022; 70:3469-3479. [PMID: 36054661 PMCID: PMC9539351 DOI: 10.1111/jgs.18010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/07/2022] [Accepted: 07/21/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Loneliness was common early in the COVID-19 pandemic due to physical distancing measures, but little is known about how loneliness persisted into later stages of the pandemic. We therefore examined longitudinal trajectories of loneliness over 18 months of the pandemic and subgroups at risk for persistent loneliness. METHODS We used data from the COVID-19 & Chronic Conditions study collected between March 27, 2020 to December 10, 2021, including 641 predominantly older adults with ≥1 chronic condition who completed six interviews at approximately 3 month intervals. Participants reported loneliness (defined as some, most, or all of the time) during the past week due to COVID-19. We used trajectory mixture models to identify clusters of individuals following similar trajectories of loneliness, then determined subgroups likely to be classified in different loneliness trajectories using multivariable regression models adjusted for sociodemographic and clinical covariates. RESULTS Participants were on average 63 years old, 61% female, 30% Black, 20% Latinx, and 29% were living below the poverty level. There was an overall reduction in loneliness over time (March to April/2020: 51% to September to December/2021: 31%, p = 0.01). Four distinct trajectory groups emerged: (1) "Persistent Loneliness" (n = 101, 16%); (2) "Adapted" (n = 141, 22%), individuals who were initially lonely, with feelings of loneliness decreasing over time; (3) "Occasional loneliness" (n = 189, 29%); and (4) "Never lonely" (n = 211, 33%). Subgroups at highest risk of the "Persistently Lonely" trajectory included those identifying as Latinx (aOR 2.5, 95% CI: 1.2, 5.2), or living in poverty (aOR 2.5; 95% CI: 1.4, 4.6). CONCLUSIONS Although loneliness declined for a majority of older adults during the pandemic in our sample, persistent loneliness attributed to the COVID-19 pandemic was common (1 in 6 adults), particularly among individuals identifying as Hispanic/Latinx or living in poverty. Interventions addressing loneliness can ease pandemic-related suffering, and may mitigate long-term mental and physical health consequences.
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Affiliation(s)
- Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California, California, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, California, USA
| | - Stephanie Batio
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Michael S Wolf
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Kenneth E Covinsky
- Division of Geriatrics, Department of Medicine, University of California, California, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, California, USA
| | - Julia Yoshino Benavente
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Carla M Perissinotto
- Division of Geriatrics, Department of Medicine, University of California, California, USA
| | - Rachel M O'Conor
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
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44
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Lee S. Loneliness, Volunteering, and Quality of Life in European Older Adults. Activities, Adaptation & Aging 2022. [DOI: 10.1080/01924788.2022.2148408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Sunwoo Lee
- The Faculty of Physical Culture, Palacký University Olomouc, Třída Míru 117, 771 11, Olomouc, Czech Republic
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45
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Hajek A, König HH. Loneliness, perceived isolation and sleep quality in later life. Longitudinal evidence from a population-based German study. Arch Gerontol Geriatr 2022; 103:104795. [PMID: 36058046 DOI: 10.1016/j.archger.2022.104795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/10/2022] [Accepted: 08/20/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To date, there is restricted knowledge regarding the association between loneliness, perceived social isolation and sleep quality based on longitudinal studies. Our aim was therefore to clarify the association between loneliness, perceived social isolation and sleep quality stratified by sex using a longitudinal approach. METHODS Longitudinal data (wave 5 and wave 6) were used from a nationally representative sample of community-dwelling individuals ≥ 40 years in Germany. In our analytical sample, n equaled 8784 observations. The Bude and Lantermann tool was used to quantify perceived social isolation and the De Jong Gierveld tool was used to measure loneliness. Relying on key items of the Pittsburgh Sleep Quality Index, sleep quality was assessed. RESULTS Increases in loneliness were associated with worsening sleep quality (in men: in two outcomes; in women: in all three outcomes). Moreover, in men, increases in perceived social isolation was associated with decreases in overall sleep quality (β = 0.10, p < 0.01), but not with the other outcomes. In contrast, perceived social isolation was not associated with changes in any of the outcome measures in women. CONCLUSIONS Increases in loneliness were particularly associated with worsening sleep quality among women, whereas the overall sleep quality decreases when perceived social isolation increases in men. Efforts to reduce perceived social isolation (men) and loneliness (in men, but particularly in women) can contribute to sleep quality in individuals aged 40 years and over in Germany.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, Hamburg 20246, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, Hamburg 20246, Germany
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46
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Goyal P, Zainul O, Marshall D, Kitzman DW. Geriatric Domains in Patients with Heart Failure with Preserved Ejection Fraction. Cardiol Clin 2022; 40:517-532. [PMID: 36210135 PMCID: PMC10282897 DOI: 10.1016/j.ccl.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Because heart failure with preserved ejection fraction (HFpEF) is closely linked to aging processes and disproportionately affects older adults, consideration of geriatric domains is paramount to ensure high-quality care to older adults with HFpEF. Multimorbidity, polypharmacy, cognitive impairment, depressive symptoms, frailty, falls, and social isolation each have important implications on quality of life and clinical events including hospitalization and mortality. There are multiple strategies to screen for these conditions. This narrative review underscores the importance of screening for multiple geriatric conditions, integrating these conditions into decision making, and addressing these conditions when caring for older adults with HFpEF.
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Affiliation(s)
- Parag Goyal
- Department of Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10023, USA.
| | - Omar Zainul
- Weill Cornell Medical College, 1300 York Avenue, New York, NY 10023, USA
| | - Dylan Marshall
- Department of Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10023, USA
| | - Dalane W Kitzman
- Department of Internal Medicine, Sections on Cardiovascular Disease and Geriatrics, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC 27157-1045, USA
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47
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Hoang P, King JA, Moore S, Moore K, Reich K, Sidhu H, Tan CV, Whaley C, McMillan J. Interventions Associated With Reduced Loneliness and Social Isolation in Older Adults: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2236676. [PMID: 36251294 PMCID: PMC9577679 DOI: 10.1001/jamanetworkopen.2022.36676] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IMPORTANCE Loneliness and social isolation are public health concerns faced by older adults due to physical, cognitive, and psychosocial changes that develop with aging. Loneliness and social isolation are associated with increased morbidity and mortality. OBJECTIVE To evaluate interventions, targeting older adults, associated with a reduction in loneliness and social isolation. DATA SOURCES OVID, CINAHL, CENTRAL, Embase, PsychINFO, Web of Science, and Scopus were searched from inception to March 2020. STUDY SELECTION Peer-reviewed randomized clinical trials measuring loneliness and social isolation or support in adults aged 65 years or older. Only English language articles were included. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened studies, extracted data, and assessed risk of bias. Random-effects models were performed to pool the overall effect size by intervention. Statistical heterogeneity was evaluated with the I2 statistic and by estimating prediction intervals. Data were analyzed from November 2021 to September 2022. MAIN OUTCOMES AND MEASURES Quantitative measures of loneliness, social isolation, or social support based on an effect size of standardized mean differences. RESULTS Seventy studies were included in the systematic review (8259 participants); 44 studies were included in the loneliness meta-analysis (33 in the community with 3535 participants; 11 in long-term care with 1057 participants), with participants' ages ranging from 55 to 100 years. Study sizes ranged from 8 to 741 participants. Interventions included animal therapy, psychotherapy or cognitive behavioral therapy, multicomponent, counseling, exercise, music therapy, occupational therapy, reminiscence therapy, social interventions, and technological interventions. Most interventions had a small effect size. Animal therapy in long-term care, when accounting for studies with no active controls, had the largest effect size on loneliness reduction (-1.86; 95% CI, -3.14 to -0.59; I2 = 86%) followed by technological interventions (videoconferencing) in long-term care (-1.40; 95% CI, -2.37 to -0.44; I2 = 70%). CONCLUSIONS AND RELEVANCE In this study, animal therapy and technology in long-term care had large effect sizes, but also high heterogeneity, so the effect size's magnitude should be interpreted with caution. The small number of studies per intervention limits conclusions on sources of heterogeneity. Overall quality of evidence was very low. Future studies should consider measures of social isolation in long-term care and identify the contextual components that are associated with a reduction in loneliness.
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Affiliation(s)
- Peter Hoang
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - James A. King
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform, Calgary, Alberta, Canada
- Data and Analytics, Alberta Health Services, Edmonton, Alberta, Canada
| | - Sarah Moore
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kim Moore
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Krista Reich
- Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Harman Sidhu
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Chin Vern Tan
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Colin Whaley
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jacqueline McMillan
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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48
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Long KM, Casey K, Bhar S, Al Mahmud A, Curran S, Hunter K, Lim MH. Understanding perspectives of older adults on the role of technology in the wider context of their social relationships. Ageing and Society. [DOI: 10.1017/s0144686x2200085x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Technological interventions are increasingly popular methods of targeting and preventing loneliness in older adults. Research has identified various factors that influence the willingness and propensity of older adults to integrate technology into their social lives and the ways in which this may enhance their social connectedness. Given prevalence rates and negative outcomes associated with loneliness for this population, further research is warranted to clarify the mechanisms through which technological interventions may decrease loneliness. This study aimed to better understand the perspectives of older adults on the role of technology in their social relationships in later life. Four focus groups were conducted with 27 older adults, aged 65–80 years. Transcripts were analysed using thematic analysis, and results were validated via written participant feedback. Participants reported technology as one of many tools used to maintain their social relationships. Their choice to use technology for social interaction was influenced by their estimation of effort required, likely quality of the interaction, and the privacy and security provided. These factors were the same as those that influenced decisions to use other methods (e.g. face-to-face meetings). Based on the results, we recommend that loneliness interventions should be technology-agnostic and multifaceted, providing a wide range of tools that recognise the technological competencies of older adults and supporting different interaction types to meet the preferences of the individual.
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49
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Döring N, Conde M, Brandenburg K, Broll W, Gross HM, Werner S, Raake A. Can Communication Technologies Reduce Loneliness and Social Isolation in Older People? A Scoping Review of Reviews. Int J Environ Res Public Health 2022; 19:ijerph191811310. [PMID: 36141581 PMCID: PMC9517063 DOI: 10.3390/ijerph191811310] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND Loneliness and social isolation in older age are considered major public health concerns and research on technology-based solutions is growing rapidly. This scoping review of reviews aims to summarize the communication technologies (CTs) (review question RQ1), theoretical frameworks (RQ2), study designs (RQ3), and positive effects of technology use (RQ4) present in the research field. METHODS A comprehensive multi-disciplinary, multi-database literature search was conducted. Identified reviews were analyzed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. A total of N = 28 research reviews that cover 248 primary studies spanning 50 years were included. RESULTS The majority of the included reviews addressed general internet and computer use (82% each) (RQ1). Of the 28 reviews, only one (4%) worked with a theoretical framework (RQ2) and 26 (93%) covered primary studies with quantitative-experimental designs (RQ3). The positive effects of technology use were shown in 55% of the outcome measures for loneliness and 44% of the outcome measures for social isolation (RQ4). CONCLUSION While research reviews show that CTs can reduce loneliness and social isolation in older people, causal evidence is limited and insights on innovative technologies such as augmented reality systems are scarce.
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Affiliation(s)
- Nicola Döring
- Media Psychology and Media Design Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
- Correspondence:
| | - Melisa Conde
- Media Psychology and Media Design Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Karlheinz Brandenburg
- Electronic Media Technology Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Wolfgang Broll
- Virtual Worlds and Digital Games Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Horst-Michael Gross
- Neuroinformatics and Cognitive Robotics Lab, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Stephan Werner
- Electronic Media Technology Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Alexander Raake
- Audiovisual Technology Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
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50
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Welch V, Ghogomu ET, Barbeau VI, Boulton E, Boutin S, Haitas N, Kneale D, Salzwedel DM, Simard R, Herbert P, Mikton C. PROTOCOL: Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map. Campbell Syst Rev 2022; 18:e1260. [PMID: 36909878 PMCID: PMC9233308 DOI: 10.1002/cl2.1260] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: the aim is to map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings.
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Affiliation(s)
- Vivian Welch
- Methods CentreBruyere Research InstituteOttawaCanada
| | | | | | - Elisabeth Boulton
- Division of Nursing, Midwifery and Social Work, School of Health SciencesUniversity of ManchesterManchesterUK
| | | | | | - Dylan Kneale
- Social Science Research Unit, EPPI‐Centre, UCL Institute of EducationUniversity College LondonLondonUK
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverCanada
| | | | - Paul Herbert
- Centre Hospitalier de l'Université de MontréalMontrealCanada
| | - Christopher Mikton
- Department of Social Determinants of HealthWorld Health OrganizationGenevaSwitzerland
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