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Pan C. Bidirectional and Dynamic Relationships Between Social Isolation and Loneliness Among Older Adults in China. J Am Med Dir Assoc 2024:S1525-8610(24)00345-1. [PMID: 38670171 DOI: 10.1016/j.jamda.2024.03.114] [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: 10/26/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES This study aimed to investigate the bidirectional associations and temporal dynamics between social isolation (SI) and loneliness among older adults. DESIGN This is a prospective cohort study. SETTING AND PARTICIPANTS With the global phenomenon of population aging, there has been a significant increase in the prevalence of SI and loneliness among older adults. These factors exert substantial impacts on the health and well-being of this population. Consequently, it is imperative to implement more effective interventions targeting SI and combating loneliness in order to enhance the overall health and well-being of older adults. METHODS Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed, focusing on individuals aged 65 and older. Generalized Cross-Lagged Modeling (GCLM) was used to assess these associations. RESULTS The findings reveal significant cross-lagged effects between SI and loneliness over the course of 16 years. Higher levels of SI at 1 time point predict increased loneliness scores in subsequent periods, and greater levels of loneliness at 1 time point predict higher SI scores in future periods. Notably, the impact of SI on loneliness is found to be larger and more enduring compared to the influence of loneliness on SI. These cross-lagged effects persist over an extended period, indicating a long-term reciprocal relationship between SI and loneliness among older adults. CONCLUSIONS AND IMPLICATIONS This study provides valuable insights into the bidirectional associations between SI and loneliness among older adults. Given that the effect of SI dominates, the findings suggest that public health strategies aimed at promoting health and well-being should prioritize interventions that enrich older adults' social networks. Emphasizing early interventions aimed at enhancing social networks is essential for promoting healthy aging and overall well-being.
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Affiliation(s)
- Chaoping Pan
- College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Pan C, Yu L, Cao N. Reciprocal and Dynamic Associations between Social Isolation, Loneliness, and Disability among Chinese Older Adults. J Am Med Dir Assoc 2024:104975. [PMID: 38583487 DOI: 10.1016/j.jamda.2024.02.013] [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: 11/28/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES This study aimed to examine reciprocal and dynamic associations between Social Isolation (SI), loneliness, and disability among Chinese older adults. DESIGN This is a prospective cohort study. SETTING AND PARTICIPANTS The global trend of population aging has resulted in a significant rise in the prevalence of disabilities, SI, and loneliness among older adults. These factors can severely impact the health and well-being of older adults. Therefore, it is crucial to implement more efficient interventions aimed at reducing disabilities, addressing SI, and combating loneliness among older adults in order to improve their overall health and well-being. METHODS Using a large, nationally representative sample spanning 16 years, we employed the general cross-lagged panel model to explore the relationships among 50,348 older adults with a mean age of 81.83 at baseline. Disability was measured by a comprehensive index tool that incorporated multiple dimensions. SI was measured using an SI index, and loneliness was evaluated using a single-item measure. RESULTS SI emerged as a stronger predictor of disability than loneliness. Longitudinal analysis revealed accumulative disadvantages in the association between SI and disability. Additionally, disability was found to contribute to increased SI and loneliness. However, our study did not detect any variance in the strength of the cross-lagged effects between social isolation and disability. CONCLUSIONS AND IMPLICATIONS The findings suggest that reducing SI is crucial for reducing disability among older adults. Initiating early interventions to minimize initial SI could aid in preventing later-life disability. Additionally, addressing disabilities may positively impact the reduction of loneliness and SI within this population.
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Affiliation(s)
- Chaoping Pan
- College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Linwei Yu
- College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
| | - Na Cao
- College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China; School of Public Health, Wuhan University, Wuhan City, Hubei Province, China.
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Pivodic L, Van den Block L, Pivodic F. Social connection and end-of-life outcomes among older people in 19 countries: a population-based longitudinal study. Lancet Healthy Longev 2024; 5:e264-e275. [PMID: 38490235 PMCID: PMC10978496 DOI: 10.1016/s2666-7568(24)00011-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Social connection is a key determinant of health, but its role in shaping end-of-life outcomes is poorly understood. We examined changes in structure, function, and quality components of social connection in older people's last years of life, and the extent to which social connection predicts end-of-life outcomes (ie, symptoms, health-care utilisation, and place of death). METHODS This study used longitudinal data of representative samples from across 18 European countries and Israel in the Survey of Health, Ageing, and Retirement in Europe (SHARE), the largest European cohort study of people aged 50 years or older. We included deceased participants of waves 4 and 6 (which contained social network modules) for whom a proxy provided an end-of-life interview. We did paired sample t-tests (for continuous variables), Wilcoxon signed-rank tests (for ordinal variables), and McNemar's tests (for non-ordinal categorical variables) to assess changes in structure, function, and quality components of social connection between waves 4 and 6. To examine social connection as a predictor of end-of-life outcomes, we used social connection data from wave 6 core interviews and end-of-life interviews from wave 7, conducted with a proxy respondent covering the deceased participant's last year of life. End-of-life outcomes included symptoms (pain, breathlessness, and anxiety or sadness) in the last month of life, health-care utilisation in the last year of life, and place of death. We conducted a mixed-effects logistic regression analysis per social connection measure, for each end-of-life outcome. FINDINGS Data were collected in 2011-12 for wave 4, 2015-16 for wave 6, and 2017-18 for wave 7. We studied 3356 individuals (mean age at death was 79·7 years [SD 10·2]), with interviews conducted, on average, 4·6 (1·2) years (wave 4) and 1·1 (0·7) years (wave 6) before death. From wave 4 to wave 6, the following changes in social connection were observed: proportion of married or partnered participants (from 1406 [60·9%] of 2310 to 1438 [57·1%] of 2518; p<0·0001), receiving personal care or practical help (from 781 [37·2%] of 2099 to 1334 [53·1%] of 2512; p<0·0001), loneliness (from mean 1·4 [SD 0·5] to 1·5 [0·6]; p<0·0001; scale 1-3), satisfaction with social network (from 8·8 [1·67] to 8·7 [1·7]; p=0·037; scale 0-10), and emotional closeness to social network (eg, from 1883 [88·8%] of 2121 to 1710 [91·3%] of 1872 participants who indicated being either very close or extremely close to social network members; p<0·0001). Higher levels of loneliness at wave 6 predicted a greater likelihood of experiencing symptoms in the last month of life (odds ratio range across symptoms: 1·29 [95% CI 1·08-1·55] to 1·58 [1·32-1·89]). Being married (1·32 [1·03-1·68]) or receiving personal care or practical help (1·25 [1·04-1·49]) predicted death in hospital. INTERPRETATION Social connection undergoes multifaceted changes towards older people's end of life, countering prevalent ideas of generally declining social trajectories. Loneliness in the final months of life might be a risk factor for end-of-life symptoms. Further research is needed to substantiate a causal relationship and to identify underpinning mechanisms, which could inform screening and prevention measures. FUNDING Research Foundation-Flanders and European Union.
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Affiliation(s)
- Lara Pivodic
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium; Vrije Universiteit Brussel (VUB), Department of Family Medicine & Chronic Care, Brussels, Belgium.
| | - Lieve Van den Block
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium; Vrije Universiteit Brussel (VUB), Department of Family Medicine & Chronic Care, Brussels, Belgium
| | - Fedja Pivodic
- World Bank, Health, Nutrition and Population Division; Washington DC, USA
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Bagade T, Mersha AG, Majeed T. The social determinants of mental health disorders among women with infertility: a systematic review. BMC Womens Health 2023; 23:668. [PMID: 38093258 PMCID: PMC10720205 DOI: 10.1186/s12905-023-02828-9] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Infertility is associated with mental health disorders in women, even if a successful pregnancy resolves infertility. However, the link between social determinants of health (SDoH) and mental health in women with infertility is not well understood. We aimed to investigate the determinants thoroughly so that mental health screening and services can be tailored to suit women with infertility who are vulnerable to mental health disorders. METHODOLOGY All observational studies that included women participants of reproductive age with infertility and assessed social determinants associated with mental health disorders were searched using a combination of keywords from MEDLINE, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science databases and published in English. Two reviewers conducted screening, data extraction, quality assessment and risk of bias. The protocol was registered on PROSPERO (number CRD42022343962). RESULTS The systematic review included 32 studies out of 3405 screened articles from January 1st 2010 to 16th October 2023. Compared to women without infertility, the prevalence of mental health disorders, including anxiety, depression, psychological distress, and stress, is high among women with infertility, with the severity being influenced by social determinants-those with higher education, employment, higher personal or family income, private health insurance, higher social support, stronger religious beliefs, and higher spiritual well-being reported better mental health outcomes. CONCLUSION The study highlights the need for early detection, tailored interventions, and integrated and comprehensive support systems to address the mental health needs of women with infertility and improve their well-being.
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Affiliation(s)
- Tanmay Bagade
- School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, 2285, Australia.
| | - Amanual Getnet Mersha
- School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, 2285, Australia
| | - Tazeen Majeed
- School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, 2285, Australia
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Pan C, Cao N. Patterns of Social Isolation and Low Social Support and Frailty Trajectories Among Chinese Older Adults. J Appl Gerontol 2023; 42:2325-2334. [PMID: 37585676 DOI: 10.1177/07334648231194508] [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: 08/18/2023] Open
Abstract
Objectives: This study aims to identify patterns of social isolation and low social support, and discover their associations with frailty trajectories among Chinese older adults. Methods: The paper used five waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2005-2018). The latent class analysis, multi-trajectory modeling, and the multinomial logistic regression approaches were used to perform the analysis. Results: The paper identified five types of social isolation and low social support, and three typical frailty trajectories. Patterns of social isolation and low social support were associated with frailty trajectories among older adults. Conclusions: Distinct patterns of social isolation and low social support were significantly correlated with frailty trajectories. To improve frailty trajectories among older adults, interventions such as Healthy China 2030 should prioritize addressing the interplay between social isolation and low social support.
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Affiliation(s)
- Chaoping Pan
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, China
| | - Na Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, China
- School of Public Health, Wuhan University, Wuhan City, China
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Xie X, Huang C, Sitar S, Qiao X. Community engagement and loneliness in older adults in China: mediation effects of social support in the wake of COVID-19. Front Public Health 2023; 11:1199577. [PMID: 38106887 PMCID: PMC10722421 DOI: 10.3389/fpubh.2023.1199577] [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: 04/03/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Loneliness is a key indicator of well-being in older adults. Drawing from the ecological model of aging, the active aging perspective, and the convoy model of social relations, this study investigates the extent community engagement influences loneliness and whether the relationship is mediated by social support during the COVID-19 pandemic. Methods Data was collected from 1,067 retired older adults in a cross-sectional design in Chengdu, China in 2022. Structural equation modeling was conducted to examine the direct and indirect effects of community engagement on loneliness through the hypothesized mediator of social support. Results The results show community engagement was positively associated with social support (β = 0.26, p < 0.001) and social support was negatively related to loneliness (β = -0.41, p < 0.001). Social support fully mediated the relationship between community engagement and loneliness. Additionally, community engagement had an indirect effect on loneliness via social support (β = -0.11, p < 0.001). Discussion The findings from the moderation analysis suggests community engagement and social support are likely to have large effects on loneliness for older adults over the age of 70 and who have low educational attainment. The findings suggest community engagement could be an important factor for improving social support and reducing loneliness amongst retired, older adults in China, especially in the wake of the COVID-19 pandemic where millions of individuals were isolated for extended periods of time.
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Affiliation(s)
- Xiaoxia Xie
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Chienchung Huang
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Sophie Sitar
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Xingyong Qiao
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
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Fonseca-Baeza S, García-Alandete J, Marco JH, Pérez Rodríguez S, Baños RM, Guillén V. Difficulties in emotional regulation mediates the impact of burden on quality of life and mental health in a sample of family members of people diagnosed with Borderline Personality Disorder. Front Psychol 2023; 14:1270379. [PMID: 38054179 PMCID: PMC10694221 DOI: 10.3389/fpsyg.2023.1270379] [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: 07/31/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023] Open
Abstract
Background Although it has been suggested that family members of persons suffering from Borderline Personality Disorder (BPD) endure high levels of burden, however, the process and the impact of this burden in their lives, and specifically the relation between the burden and emotional regulation has not been broadly investigated among this population. The main objective of this study is to examine the impact of burden on quality of life and depression, anxiety and stress, as mediated by difficulties in emotional regulation in family members of persons diagnosed with BPD. Method Participants were 167 family members of persons diagnosed with BPD. The Burden Assessment Scale, Difficulties in Emotion Regulation Scale, Multicultural Quality of Life Index, and Depression Anxiety Stress Scale-21 were filled out. Mediation analysis was conducted using the Maximum Likelihood estimator, bootstrap method and listwise deletion for missing data. Results Burden showed a significant, negative effect on quality of life and positive on depression, anxiety and stress. Difficulties in emotion regulation significantly mediated these relations. After accounting for the mediating role of difficulties in emotion regulation, burden still had an impact on quality of life, depression, anxiety and stress. Women showed a higher level in both burden and stress than men. The caregivers with secondary and higher studies showed higher levels in burden than those with no studies. Not significant differences in burden, emotion regulation, depression, anxiety and stress were found related to marital status. Conclusion Difficulties in emotion regulation mediate the relations between burden and quality of life, depression, anxiety, and stress. Family members could engage in group interventions designed specifically for family members of people with BPD, oriented toward understanding the disorder or learning skills.
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Affiliation(s)
- Sara Fonseca-Baeza
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Joaquín García-Alandete
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - José Heliodoro Marco
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Sandra Pérez Rodríguez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Rosa M. Baños
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Verónica Guillén
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
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Amendola S, Volken T, Zysset A, Huber M, von Wyl A, Dratva J. Trend in loneliness among Swiss university students during the first year of the COVID-19 pandemic. Health Psychol Rep 2023; 12:53-67. [PMID: 38425886 PMCID: PMC10900978 DOI: 10.5114/hpr/169721] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 07/03/2023] [Accepted: 07/17/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The need to maintain physical and social distance between people and the stay-at-home recommendation/order to contain the spread of COVID-19 have raised concerns about the possible increase in loneliness. However, few studies have analyzed trends or changes in loneliness in samples of young adults. The present study aimed to explore the prevalence of loneliness and its change during the COVID-19 pandemic. PARTICIPANTS AND PROCEDURE This is a repeated cross-sectional study analyzing data collected through six online surveys between April 2020 and March 2021 from 5,669 university students in Switzerland. Logistic regression models were used to examine trends in loneliness and associations between loneliness, well-being, life at home, COVID-19 symptoms and tests. RESULTS Loneliness decreased between April 2020 and May-June 2020. In contrast, loneliness was higher in December 2020, January and March 2021 compared to April 2020. Loneliness was associated with younger age, studying architecture, design and civil engineering or engineering, enjoying time spent with family/partner, experiencing tensions and conflicts at home, boredom, feeling locked up and subjective well-being and current health. CONCLUSIONS Our findings highlight an increase in loneliness during the second wave of the COVID-19 pandemic, although a seasonality effect cannot be excluded. Public health systems and educational institutions need to monitor the effects of social distancing measures and reduced social contact on students' loneliness and well-being.
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Affiliation(s)
- Simone Amendola
- Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Thomas Volken
- Department of Health, Institute of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Annina Zysset
- Department of Health, Institute of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Marion Huber
- Department of Health, Institute of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Agnes von Wyl
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Julia Dratva
- Department of Health, Institute of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
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Palace M, Zamazii O, Terbeck S, Bokszczanin A, Berezovski T, Gurbisz D, Szwejka L. Mapping the factors behind ongoing war stress in Ukraine-based young civilian adults. Appl Psychol Health Well Being 2023. [PMID: 37727930 DOI: 10.1111/aphw.12493] [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: 12/29/2022] [Accepted: 09/03/2023] [Indexed: 09/21/2023]
Abstract
While the literature on well-being and stress following natural disasters is well-developed, it is less so when it comes to ongoing war experiences. Between September and October of 2022, 223 Ukraine-based civilian adults (156 women and 67 men) completed a survey measuring symptoms of post-traumatic stress disorder (PTSD), peritraumatic experiences, paranoia, quality of life, death anxiety, anxiety about weapons of mass destruction and depression (i.e. assumed 'war consequence' factors), as well as perceived social support, resilience, loneliness and expected military support from the West (i.e. assumed 'buffer' factors). Our exploratory structural equation model (SEM) suggests that Perceived Social Support predicted fewer PTSD Symptoms and more Peritraumatic Experiences. The regression modelling, however, shows that Perceived Social Support was also positively correlated with Peritraumatic Experiences. Highlighting the need for a civilian war stress buffer disruption theory, we argue that when composed of one's circle of family and friends, social support could likely mean greater exposure to war stressors through the mutual sharing of ongoing war experiences with no end in sight. Such a possible war stress sharing deterioration effect would imply that Perceived Social Support may compound peritraumatic distress if the support in question is offered by those facing the same grim reality.
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Affiliation(s)
- Marek Palace
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Oksana Zamazii
- Department of Accounting, Audit and Taxation, Khmelnytskyi National University, Khmelnytskyi, Ukraine
| | - Sylvia Terbeck
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | | | - Tetyana Berezovski
- Department of Mathematics, St Joseph's University, Philadelphia, Pennsylvania, USA
| | - Dominica Gurbisz
- Doctoral School of Social Sciences, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Lukasz Szwejka
- Institute of Pedagogy, Jagiellonian University, Kraków, Poland
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Rhubart D, Kowalkowski J, Wincott L. The Built Environment and Social and Emotional Support among Rural Older Adults: The Case for Social Infrastructure and Attention to Ethnoracial Differences. Rural Sociol 2023; 88:731-762. [PMID: 37829666 PMCID: PMC10567077 DOI: 10.1111/ruso.12491] [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] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 05/01/2023] [Indexed: 10/14/2023]
Abstract
Social and emotional support (SaES) is essential for older adult mental health and is shaped by individual-level factors and the built environment. However, much of the focus on the built environment, and specifically social infrastructure - the physical places that facilitate social interaction and social tie formation - relies heavily on urban settings or samples with limited diversity. Consequently, there is little understanding if social infrastructure matters for the SaES of older adults in rural America, and across race and ethnicity. Therefore, we use social cohesion as a conceptual lens and the community gerontology framework to determine if availability of social infrastructure is associated with SaES among older adults in rural America and if this relationship varies across race and ethnicity. Using data from 110,850 rural older adults from the Behavioral Risk Factors Surveillance System and data from the National Neighborhood Data Archive, we show that among rural ethnoracial minority older adults, higher densities of social infrastructure are associated with higher SaES. This is not true for rural non-Hispanic White older adults. Results highlight the importance of accounting for both social infrastructure as part of the built environment and heterogeneity across race and ethnicity in studies that examine older adult mental and emotional health.
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Affiliation(s)
- Danielle Rhubart
- The Pennsylvania State University, Biobehavioral Health Building, University Park PA 16802, USA
| | - Jennifer Kowalkowski
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Logan Wincott
- The Pennsylvania State University, University Park, PA, USA
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Pan C, Cao N. Dual trajectories of depression and social participation among Chinese older adults. Geriatr Nurs 2023; 53:153-161. [PMID: 37540910 DOI: 10.1016/j.gerinurse.2023.07.013] [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: 06/17/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES This study aimed to investigate the dual trajectories of social participation (SP) and depression among older adults, and explore common factors that may influence both trajectories. METHODS The study utilized data from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). The dual-trajectory model was employed to estimate the dual trajectories of SP and depression. RESULTS This study identified two SP and three depression trajectories. The results revealed that the reciprocal relationship between SP and depression trajectories is confirmed in all sub-groups of the dual trajectories. Our study identified six distinct sub-groups of individuals based on their SP and depression trajectories and some commen risk factors of SP and depression trajectories. CONCLUSIONS Related intervention policies should consider the dual trajectories of SP and depression and focus on subgroups with high vulnerability, such as high depression but low SP. Additionally, attention should be given to addressing the common risk factors that underlie these trajectories.
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Affiliation(s)
- Chaoping Pan
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Na Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China; School of Public Health, Wuhan University, Wuhan City, Hubei Province, China.
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Zhang C, Dong C. The Influence of Social Support on the Mental Health of Elderly Individuals in Healthy Communities with the Framework of Mental Toughness. Psychol Res Behav Manag 2023; 16:2977-2988. [PMID: 37559780 PMCID: PMC10408709 DOI: 10.2147/prbm.s413901] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/28/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION This work aims to explore the impacts of social support measures such as analyzing greening urban spaces and improving greenspace quality on the mental health of the elderly based on the mental resilience framework to build a healthy community. METHODS Through literature research and a questionnaire survey, this study designs a questionnaire including basic information, a life satisfaction scale, a positive and negative emotion scale, social support rating scale, a life orientation test-revised version, and psychological resilience scale. In order to classify the scales, machine learning (ML) approaches are applied in this work. RESULTS The results demonstrate great variations in the scores of the elderly with various health problems in the domain of psychological resilience (p<0.001). Social support and subjective well-being are strongly related (p<0.001). Additionally, positive correlations are observed among perceived, objective, and support use (p<0.001). CONCLUSION Finally, it is found that psychological resilience and social support play a significant role in mediating mental health problems in elderly individuals. Therefore, social support measures such as analyzing greening urban spaces and improving greenspace quality can be adopted to improve the mental health of the elderly to build healthy communities. On this basis, this work is of certain reference value and practical significance for the construction of healthy communities and the positive influence on the mental health of elderly individuals.
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Affiliation(s)
- Cheng Zhang
- College of Law, Jiangnan University, Wuxi, Jiangsu, 214122, People’s Republic of China
| | - Caisheng Dong
- School of Philosophy and Sociology, Jilin University, Changchun, Jilin, 130012, People’s Republic of China
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Carmel S, O'Rourke N, Tovel H, Raveis VH, Antler N, Cohn-Schwartz E. Social Support and Commitment to Life and Living: Bidirectional Associations in Late Life over Time. Healthcare (Basel) 2023; 11:1965. [PMID: 37444799 DOI: 10.3390/healthcare11131965] [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: 06/20/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES This study aims to enhance the understanding of longitudinal associations between two important facets of well-being in late life: social support and commitment to life and living (CTL). METHODS Structured home interviews were conducted with 824 Israelis ≥75 years of age, with three annual data collection timepoints. We hypothesized and tested a cross-lagged, longitudinal structural equation model (SEM) in which CTL and social support were assumed to predict each other over time, covarying for previously reported CTL and social support. RESULTS Social support has a positive, contemporaneous effect, predicting commitment to living at T1 and T3, while CTL predicts social support the following year (i.e., T1-T2 & T2-T3). Satisfaction with relationships significantly contributes to measurement of both latent constructs at each point of data collection. DISCUSSION Commitment to life and living and social support are intertwined phenomena. Whereas social support has a concomitant effect on CTL, the effect of CTL on social support emerges over time. This suggests that greater social support fosters greater CTL, leading older adults to nurture social networks and relationships; the effect of which is greater social support in the future. The implications of these results warrant further research over longer periods and across cultures.
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Affiliation(s)
- Sara Carmel
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
| | - Norm O'Rourke
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
- Department of Psychology, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
| | - Hava Tovel
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
| | - Victoria H Raveis
- Psychosocial Research Unit on Health, Aging and the Community, New York University College of Dentistry, New York, NY 10010-2314, USA
| | - Naama Antler
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
| | - Ella Cohn-Schwartz
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
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14
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Moitra S, Adan A, Akgün M, Anderson A, Brickstock A, Eathorne A, Farshchi Tabrizi A, Haldar P, Henderson L, Jindal A, Jindal SK, Kerget B, Khadour F, Melenka L, Moitra S, Moitra T, Mukherjee R, Semprini A, Turner AM, Murgia N, Ferrara G, Lacy P. Less Social Deprivation Is Associated With Better Health-Related Quality of Life in Asthma and Is Mediated by Less Anxiety and Better Sleep Quality. J Allergy Clin Immunol Pract 2023; 11:2115-2124.e7. [PMID: 37087095 DOI: 10.1016/j.jaip.2023.03.052] [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] [Received: 10/10/2022] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Previous studies on health-related quality of life (HRQoL) in asthma have mainly focused on clinical and environmental determinants. Little is known about the role of social determinants on HRQoL in asthma. OBJECTIVES We aimed to investigate the association between social deprivation and HRQoL in asthma. METHODS A total of 691 adult asthmatics from Canada, India, New Zealand, and the United Kingdom were administered a digital questionnaire containing demographic information and questions about social and psychological attributes, sleep disturbances, and alcohol abuse. HRQoL was measured using the Short Form of the Chronic Respiratory Questionnaire (SF-CRQ). We analyzed the direct and indirect relationships between social deprivation and HRQoL using structural equation models with social deprivation as a latent variable. We tested for mediation via anxiety, depression, sleep disturbances, and alcohol abuse. RESULTS We found that less social deprivation (latent variable) was directly associated with better SF-CRQ domain scores such as dyspnea (regression coefficient β: 0.33; 95% confidence interval [CI]: 0.07 to 0.58), fatigue (β: 0.39; 95% CI: 0.14 to 0.64), and emotional function (β: 0.37; 95% CI: 0.11 to 0.62), but with the worse mastery score (β: -0.29; 95% CI: -0.55 to -0.03); however, those associations varied across participating countries. We also observed that among all individual social deprivation indicators, education, companionship, emotional support, instrumental support, and social isolation were directly associated with HRQoL, and the relationship between social deprivation and HRQoL was mediated through anxiety and sleep disturbances. CONCLUSIONS Our results demonstrated that less social deprivation was directly, and indirectly through less anxiety and better sleep quality, associated with better HRQoL in asthma.
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Affiliation(s)
- Subhabrata Moitra
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Metin Akgün
- Department of Chest Diseases, Ataturk University, Erzurum, Turkey; Department of Pulmonary Medicine, Ağrı İbrahim Çeçen University, School of Medicine, Ağrı, Turkey
| | | | - Amanda Brickstock
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Allie Eathorne
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Ali Farshchi Tabrizi
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Prasun Haldar
- Department of Medical Laboratory Technology, Supreme Institute of Management and Technology, Mankundu, West Bengal, India; Department of Physiology, West Bengal State University, Barasat, West Bengal, India
| | - Linda Henderson
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | | | | | - Bugra Kerget
- Department of Chest Diseases, Ataturk University, Erzurum, Turkey
| | - Fadi Khadour
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Lyle Melenka
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Saibal Moitra
- Department of Pulmonary Medicine, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Tanusree Moitra
- Department of Psychology, Barrackpore Rashtraguru Surendrananth College, Barrackpore, West Bengal, India
| | - Rahul Mukherjee
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Alex Semprini
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Alice M Turner
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Ferrara
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Paige Lacy
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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15
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Reine I, Miķelsone M, Guðmundsson H, Ivanovs A, Tomsone S, Guðmundsson HS. Loneliness, social isolation and ageing: a methodological approach to compare Latvian and Icelandic older populations in the course of COVID-19 pandemic. Res Sq 2023:rs.3.rs-2870118. [PMID: 37205568 PMCID: PMC10187401 DOI: 10.21203/rs.3.rs-2870118/v1] [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] [Indexed: 05/21/2023]
Abstract
Background Feelings of loneliness and social isolation are common among the elderly, affecting both health and wellbeing. The COVID-19 pandemic has altered social connections through health precautions, restrictions and other factors. However, limited research has been conducted on how older people's health and wellbeing in different countries has been impacted by the COVID-19 pandemic. The aim of this study was to develop methodology that would allow us to compare elderly populations, aged 67 + in Latvia and Iceland, and to discuss the potential impact of diverging factors on the association between loneliness, social isolation and health. Methods Quantitative data on 420 respondents from Wave 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was utilized in Latvia. Data on health and wellbeing of elderly in Iceland from a HL20 study with 1033 respondents was used to provide comparative analytic material for studying the differences between Latvia and Iceland, and within each country. Results The study revealed considerable differences between the countries regarding the frequency of loneliness and social isolation. About 80% of Latvian respondents felt socially isolated and 45% were lonely, compared to 42.7% socially isolated and 30% lonely Icelanders. In general, more elderly people in Latvia experienced difficulties than their peers in Iceland. Social isolation tends to differ across genders and age groups in both countries. This is related to marital and employment status, financial situation, and education. COVID-19 had a stronger deteriorating effect on mental and physical health among both lonely Latvian and Icelandic respondents. However, health deterioration was stronger amongst more socially isolated Icelanders compared to Latvians. Conclusions The study suggests that social isolation is a contributing factor and increases the risk of loneliness, which might have been enhanced by restrictions during the COVID-19 pandemic.
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16
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Simons RL, Ong ML, Lei MK, Beach SRH, Zhang Y, Philibert R, Mielke MM. Changes in Loneliness, BDNF, and Biological Aging Predict Trajectories in a Blood-Based Epigenetic Measure of Cortical Aging: A Study of Older Black Americans. Genes (Basel) 2023; 14:genes14040842. [PMID: 37107599 PMCID: PMC10138024 DOI: 10.3390/genes14040842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/17/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
A recent epigenetic measure of aging has developed based on human cortex tissue. This cortical clock (CC) dramatically outperformed extant blood-based epigenetic clocks in predicting brain age and neurological degeneration. Unfortunately, measures that require brain tissue are of limited utility to investigators striving to identify everyday risk factors for dementia. The present study investigated the utility of using the CpG sites included in the CC to formulate a peripheral blood-based cortical measure of brain age (CC-Bd). To establish the utility of CC-Bd, we used growth curves with individually varying time points and longitudinal data from a sample of 694 aging African Americans. We examined whether three risk factors that have been linked to cognitive decline—loneliness, depression, and BDNFm—predicted CC-Bd after controlling for several factors, including three new-generation epigenetic clocks. Our findings showed that two clocks—DunedinPACE and PoAm—predicted CC-BD, but that increases in loneliness and BDNFm continued to be robust predictors of accelerated CC-Bd even after taking these effects into account. This suggests that CC-Bd is assessing something more than the pan-tissue epigenetic clocks but that, at least in part, brain health is also associated with the general aging of the organism.
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Affiliation(s)
- Ronald L. Simons
- Department of Sociology, University of Georgia, Athens, GA 30602, USA
- Correspondence: ; Tel.: +1-706-424-2626
| | - Mei Ling Ong
- Center for Family Research, University of Georgia, Athens, GA 30602, USA
| | - Man-Kit Lei
- Department of Sociology, University of Georgia, Athens, GA 30602, USA
| | | | - Yue Zhang
- Department of Sociology, University of Georgia, Athens, GA 30602, USA
| | - Robert Philibert
- Department of Psychiatry, University of Iowa School of Medicine, Iowa City, IA 52242, USA
| | - Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA
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17
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Teshale AB, Htun HL, Hu J, Dalli LL, Lim MH, Neves BB, Baker JR, Phyo AZZ, Reid CM, Ryan J, Owen AJ, Fitzgerald SM, Freak-Poli R. The relationship between social isolation, social support, and loneliness with cardiovascular disease and shared risk factors: A narrative review. Arch Gerontol Geriatr 2023; 111:105008. [PMID: 37003026 DOI: 10.1016/j.archger.2023.105008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/27/2022] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the greatest contributor to global morbidity and mortality. Poor social health plays a critical role in CVD incidence. Additionally, the relationship between social health and CVD may be mediated through CVD risk factors. However, the underlying mechanisms between social health and CVD are poorly understood. Certain social health constructs (social isolation, low social support and loneliness) have complicated the characterisation of a causal relationship between social health and CVD. AIM To provide an overview of the relationship between social health and CVD (and its shared risk factors). METHOD In this narrative review, we examined published literature on the relationship between three social health constructs (social isolation, social support, and loneliness) and CVD. Evidence was synthesised in a narrative format, focusing on the potential ways in which social health affects CVD, including shared risk factors. RESULTS The current literature highlights an established relationship between social health and CVD with a likelihood for bi-directionality. However, there is speculation and varied evidence regarding how these relationships may be mediated through CVD risk factors. CONCLUSIONS Social health can be considered an established risk factor for CVD. However, the potential bi-directional pathways of social health with CVD risk factors are less established. Further research is needed to understand whether targeting certain constructs of social health may directly improve the management of CVD risk factors. Given the health and economic burdens of poor social health and CVD, improvements to addressing or preventing these interrelated health conditions would have societal benefits.
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Affiliation(s)
| | - Htet Lin Htun
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Jessie Hu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lachlan L Dalli
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
| | - Michelle H Lim
- Prevention Research Collaboration, School of Public Health, The University of Sydney, New South Wales, Australia.
| | | | - J R Baker
- School of Health, Southern Cross University, Australia; Primary & Community Care Limited, Australia.
| | - Aung Zaw Zaw Phyo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; School of Population Health, Curtin University, Perth, Western Australia, Australia.
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Sharyn M Fitzgerald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
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18
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Freak-Poli R, Hu J, Phyo AZZ, Barker SF. Social Isolation and Social Support Influence Health Service Utilisation and Survival after a Cardiovascular Disease Event: A Systematic Review. Int J Environ Res Public Health 2023; 20:4853. [PMID: 36981761 PMCID: PMC10049557 DOI: 10.3390/ijerph20064853] [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] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
Both cardiovascular disease (CVD) and social health carry high health and economic burdens. We undertook a systematic review to investigate the association between social isolation, low social support, and loneliness with health service utilisation and survival after a CVD event among people living in Australia and New Zealand. Four electronic databases were systematically searched for the period before June 2020. Two reviewers undertook the title/abstract screen. One reviewer undertook a full-text screen and data extraction. A second author checked data extraction. Of 756 records, 25 papers met our inclusion criteria. Included studies recruited 10-12,821 participants, aged 18-98 years, and the majority were males. Greater social support was consistently associated with better outcomes on four of the five themes (discharge destination, outpatient rehabilitation attendance, rehospitalisation and survival outcomes; no papers assessed the length of inpatient stay). Positive social health was consistently associated with better discharge designation to higher independent living. As partner status and living status did not align with social isolation and social support findings in this review, we recommend they not be used as social health proxies. Our systematic review demonstrates that social health is considered in cardiac care decisions and plays a role in how healthcare is being delivered (i.e., outpatient, rehabilitation, or nursing home). This likely contributes to our finding that lower social support is associated with high-intensity healthcare services, lower outpatient rehabilitation attendance, greater rehospitalisation and poorer survival. Given our evidence, the first step to improve cardiac outcomes is acknowledging that social health is part of the decision-making process. Incorporating a formal assessment of social support into healthcare management plans will likely improve cardiac outcomes and survival. Further research is required to assess if support person/s need to engage in the risk reduction behaviours themselves for outpatient rehabilitation to be effective. Further synthesis of the impact of social isolation and loneliness on health service utilisation and survival after a CVD event is required.
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Affiliation(s)
- Rosanne Freak-Poli
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC 3168, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Jessie Hu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Aung Zaw Zaw Phyo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - S. Fiona Barker
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
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19
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Goldman AW, Compernolle EL. Personal network size and social accompaniment: Protective or risk factor for momentary loneliness, and for whom? Soc Ment Health 2023; 13:23-44. [PMID: 38665906 PMCID: PMC11045043 DOI: 10.1177/21568693221142336] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Personal networks yield important health benefits for individuals, in part by providing more opportunities to be in the company of others throughout daily life. Social accompaniment is generally believed to protect against momentary feelings of loneliness, although this hypothesis remains understudied. We examine how personal network size shapes older adults' experiences of momentary loneliness and whether this association varies by momentary social accompaniment. We use three waves of ecological momentary assessments (EMA; N = 12,359) and personal network data from 343 older adults in the Chicago Health and Activity in Real-Time study. Older adults with large personal networks experienced more intense momentary loneliness compared to those with smaller social networks when they were momentarily alone. This association was more pronounced among men. We discuss how research approaches that bridge global and momentary measures of social connectedness can reveal important nuances of our understanding of how interpersonal factors influence later-life well-being over time.
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20
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Craig H, Gasevic D, Ryan J, Owen A, McNeil J, Woods R, Britt C, Ward S, Freak-Poli R. Socioeconomic, Behavioural, and Social Health Correlates of Optimism and Pessimism in Older Men and Women: A Cross-Sectional Study. Int J Environ Res Public Health 2023; 20:3259. [PMID: 36833951 PMCID: PMC9961087 DOI: 10.3390/ijerph20043259] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Optimism is a disposition characterised by positive future expectancies, while pessimism is characterised by expecting the worst. High optimism and low pessimism promote the health of older adults and may potentiate full engagement in life. We identified socioeconomic, behavioural, and social factors associated with optimism and pessimism in older adults. METHODS Participants included 10,146 community-dwelling, apparently healthy Australian adults aged 70 years and over from the ASPREE Longitudinal Study of Older Persons (ALSOP). Optimism and pessimism were measured using the revised Life Orientation Test. Cross-sectional ordinal logistic regression was used to determine the socioeconomic, behavioural, and social health factors associated with optimism and pessimism. RESULTS Higher education, greater physical activity, lower loneliness, and volunteering were associated with higher optimism and lower pessimism. Low social support was associated with higher pessimism. Higher socioeconomic advantage, greater income, and living alone were associated with lower pessimism. Women were more optimistic and less pessimistic than men. The association of age, smoking status, and alcohol consumption with optimism and pessimism differed for men and women. CONCLUSIONS Factors associated with higher optimism and lower pessimism were also those demonstrated to support healthy ageing. Health-promotion action at the individual level (e.g., smoking cessation or regular physical activity), health professional level (e.g., social prescribing or improving access and quality of care for all older adults), and community level (e.g., opportunities for volunteer work or low-cost social activities for older adults) may improve optimism and reduce pessimism, possibly also promoting healthy ageing.
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Affiliation(s)
- Heather Craig
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Centre for Global Health, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - John McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Robyn Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Carlene Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Stephanie Ward
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia
- Department of Geriatric Medicine, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC 3004, Australia
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21
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Edwards K, Cowan D, Brunero S. Perspective: Coping with Covid-19: An isolation risk assessment and management guideline for healthcare staff. Int J Ment Health Nurs 2023; 32:337-347. [PMID: 36385730 DOI: 10.1111/inm.13093] [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] [Accepted: 10/25/2022] [Indexed: 11/18/2022]
Abstract
The mental health consequences of pandemic isolation have been well documented extending from psychological conditions such as anxiety and depression to increased falls risk, medication errors and delirium. Whilst risk factors associated with isolation are known, there remains a gap in the guidance for healthcare staff on how to assess for these risks and develop effective management plans. Using a structured professional judgement (SPJ) approach and the author's recent experience providing consultation and leadership to clinical staff working with at-risk patients during the pandemic, an isolation risk assessment and management guideline was developed. SPJ is an evidenced-based analytical method used to understand and mitigate risk that was primarily developed for the assessment and management of aggression and violence. This paper discusses an evidenced-based process used to develop the guideline and the application of its use from the author's clinical experience.
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Affiliation(s)
- Kim Edwards
- Integrated Mental Health and Alcohol and Other Drugs Services, Mid North Coast Local Health District, Coffs Harbour, New South Wales, Australia
| | - Darrin Cowan
- Integrated Mental Health and Alcohol and Other Drugs Services, Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia
| | - Scott Brunero
- Mental Health Liaison, Prince of Wales Hospital, Randwick, New South Wales, Australia.,Casual Academic University of Technology, Sydney, New South Wales, Australia
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22
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Calatayud E, Ferreira C, Oliván-Blázquez B, Aguilar-Latorre A, Gómez-Soria I. Sex-Moderated Socio-Labor Aspects as Mediators of a Cognitive Stimulation Program in Older Adults: Randomized Clinical Trial. J Appl Gerontol 2023:7334648231154040. [PMID: 36724893 DOI: 10.1177/07334648231154040] [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: 02/03/2023] Open
Abstract
Cognitive stimulation is essential for successful aging. The influence of sex and socio-occupational elements on this area remains unknown. This study aimed to analyze the possible mediation of those elements in the effectiveness of a cognitive stimulation program in primary care. A randomized clinical trial was conducted with 232 adults aged 65 years or older without cognitive impairment. The intervention produced significant cognitive improvements. Women improved independently of social and occupational factors, while men's improvement occurred at a low role level (zero to one), a medium level of interests (two to three), with a medium level of mental occupation (neither high nor low), and with marked personal values. The mediating variables were the intervention group in both sexes and, also in men, a low and medium role level. Therefore, the intervention and roles appear as mediating variables moderated by sex. In conclusion, cognitive stimulation programs should be adapted.
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Affiliation(s)
- Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, 16765University of Zaragoza, Zaragoza, Spain.,Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Chelo Ferreira
- Department of Applied Mathematics and IUMA, Faculty of Veterinary Sciences, 16765University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,Department of Psychology and Sociology, Faculty of Social and Labor Sciences, 16765University of Zaragoza, Zaragoza, Spain
| | | | - Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, 16765University of Zaragoza, Zaragoza, Spain.,Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
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23
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Lin HY, Lin YC, Chen LK, Hsiao FY. Untangling the Complex Interplay between Social Isolation, Anorexia, Sarcopenia, and Mortality: Insights from a Longitudinal Study. J Nutr Health Aging 2023; 27:797-805. [PMID: 37960901 DOI: 10.1007/s12603-023-1993-y] [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: 06/20/2023] [Accepted: 09/03/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Social isolation is a pervasive and debilitating condition that has adverse prognostic impacts. This condition often co-occurs with other geriatric syndromes, further exacerbating negative health outcomes. Given these considerations, the present study aims to elucidate the roles of social isolation in older adults with anorexia of aging and/or sarcopenia with respect to long-term mortality using a nationally representative cohort study. METHODS Data were obtained from the Taiwan Longitudinal Study on Aging (TLSA), with a sample size of 3,762 study participants aged 50 years and older. Data from 1999 (wave 4) to 2015 (wave 9) were analyzed. The TLSA questionnaire was used to define social isolation, anorexia, and sarcopenia. Logistic regressions were employed to explore the associations between social isolation, anorexia, and sarcopenia. The Cox proportional hazard model was utilized to examine the synergistic effects of social isolation and anorexia or sarcopenia on 16-year all-cause mortality. RESULTS After controlling for demographic information and comorbidities, older adults with social isolation were significantly associated with anorexia (adjusted odds ratio [aOR] 1.46 [95% confidence interval: 1.00-2.12, p=0.0475]) and sarcopenia (aOR 1.35 [95% CI: 1.12-1.64, p=0.0021]). Furthermore, the synergistic effects of social isolation with anorexia (aOR 1.65 [95% CI: 1.25-2.18, p=0.0004]) or sarcopenia (aOR 1.65 [95% CI: 1.42-1.92, p<0.0001]) were both significantly associated with higher risks of all-cause mortality, while social isolation alone revealed borderline statistical significance. CONCLUSIONS Our findings indicate that social isolation is closely linked to anorexia and sarcopenia among middle-aged and older adults. Additionally, social isolation significantly exacerbates the long-term mortality risk associated with anorexia of aging and sarcopenia. However, social isolation alone appears to have borderline long-term mortality risk in this cohort. These findings underscore the importance of addressing social isolation in older adults with anorexia and/or sarcopenia to optimize their health outcomes and mitigate long-term mortality risk.
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Affiliation(s)
- H-Y Lin
- Fei-Yuan Hsiao, Ph.D., Professor and Director, Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Linsen S. Rd, Taipei 10050, Taiwan. Tel.: 886-2-33668787, E-mail: ; Liang-Kung Chen, Professor, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei 11217, Taiwan. Tel: +886-2-28757830; Fax: +886-2-28757711; E-mail:
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Tseng YC, Gau BS, Hsieh YS, Liu TC, Huang GS, Lou MF. Physical function mediates the effects of sensory impairment on quality of life in older adults: Cross-sectional study using propensity-score weighting. J Adv Nurs 2023; 79:101-112. [PMID: 36017542 DOI: 10.1111/jan.15423] [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: 12/23/2021] [Revised: 06/24/2022] [Accepted: 08/03/2022] [Indexed: 12/15/2022]
Abstract
AIMS To investigate the effect of sensory impairment on quality of life in older adults and to assess the role of physical function as a mediator of the effect of the sensory impairment on quality of life. DESIGN A cross-sectional study. METHODS Older adults aged ≥65 years (N = 600) were recruited from January 2019 to May 2020. Hearing and visual function were measured with pure-tone audiometry and Snellen visual acuity tests, respectively. Quality of life (World Health Organization Quality of Life Scale Brief Version), physical function (Multidimensional Functional Assessment Questionnaire) and sociodemographic characteristics were reported by participants using interviewer-administered questionnaires. Propensity score weighting analysis was conducted based on generalized propensity scores via multinominal logistic regression for age, gender, education, income, and comorbidities. The difference in the quality of life was tested by applying a one-way analysis of variance. Multiple mediation analysis was conducted to explore the direct, indirect, and total effects of sensory impairment on quality of life through physical function. RESULTS After propensity score weighting adjustment, when compared with participants with no sensory impairment, participants with dual sensory impairment had the worst quality of life, followed by visual impairment and then hearing impairment. Physical function statistically significantly mediated the effect of hearing impairment, visual impairment and dual sensory impairment on quality of life in older adults. CONCLUSION Our findings demonstrated that the negative effect of the sensory impairment on quality of life in older adults was mediated through physical function. IMPACT The convergence of an increasing ageing population and the prevalence of sensory impairment presents a significant global health burden. This study demonstrated that physical function was a mediator of quality of life in older adults. Designing appropriate physical activity interventions for older adults with sensory impairment could serve to enhance physio-psychological health and improve quality of life.
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Affiliation(s)
- Ya-Chuan Tseng
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Bih-Shya Gau
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yeu-Sheng Hsieh
- Department of Bio-Industry Communication & Development, College of Bio-Resources & Agriculture, National Taiwan University, Taipei, Taiwan
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Guey-Shiun Huang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Leach MJ, Ward B, Kippen R, Quinn B, Agius PA, Sutton K, Peterson J, Dietze PM. Level and correlates of social support in a community-based sample of Australians who primarily smoke methamphetamine. Health Soc Care Community 2022; 30:e4950-e4960. [PMID: 35833453 PMCID: PMC10946876 DOI: 10.1111/hsc.13907] [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] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/06/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Little is known about the level and correlates of social support amongst people who use methamphetamine. We aimed to describe, and determine characteristics associated with, social support amongst a community-recruited cohort of Australians who primarily smoked methamphetamine. A cross-sectional study was conducted with data from the Victorian Methamphetamine Cohort Study (VMAX). Adults (aged ≥18 years) who used methamphetamine were recruited from June 2016 to March 2020 across metropolitan and non-metropolitan areas using convenience, snowball, and respondent-driven sampling. Social support was measured using the seven-item Enhancing Recovery In Coronary Heart Disease (ENRICHD) Social Support Inventory (ESSI). Characteristics independently associated with ESSI quartiles were assessed via multivariable partial proportional odds regression. Overall, 718 participants were included for complete-case analysis. Their mean (standard deviation [SD]) age was 34.7 (9.7) years and 62% were male. The mean (SD) and median (lower quartile-upper quartile) ESSI scores were 22.6 (7.6) and 24 (16-29), respectively, on a scale of 8 to 34 where higher scores denote better self-perceived social support. Characteristics independently associated with lower ESSI included past-year homelessness (adjusted odds ratio [aOR] = 0.49, 95% confidence interval [CI] = 0.36-0.66), moderate/severe depression (aOR = 0.60, 95% CI = 0.42-0.86), increasing age relative to <30 years (aOR[30-39] = 0.61, 95% CI = 0.41-0.91; aOR[≥40] = 0.56, 95% CI = 0.35-0.91) and greater than fortnightly methamphetamine use (aOR = 0.69, 95% CI = 0.52-0.91). Characteristics independently associated with higher ESSI were employment (aOR = 1.51, 95% CI = 1.06-2.14) and female gender (aOR = 1.39, 95% CI = 1.00-1.92). Social support services for people who use methamphetamine could be targeted and tailored to subgroups defined by correlates of social support, such as those who experience homelessness, depression or unemployment.
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Affiliation(s)
| | - Bernadette Ward
- School of Rural HealthMonash UniversityMelbourneAustralia
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
| | - Rebecca Kippen
- School of Rural HealthMonash UniversityMelbourneAustralia
| | - Brendan Quinn
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- Australian Institute of Family StudiesMelbourneAustralia
| | - Paul A. Agius
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | - Keith Sutton
- School of Rural HealthMonash UniversityMelbourneAustralia
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
| | | | - Paul M. Dietze
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- National Drug Research InstituteCurtin UniversityMelbourneAustralia
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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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Freak‐Poli R, Phyo AZZ, Hu J, Barker SF. Are social isolation, lack of social support or loneliness risk factors for cardiovascular disease in Australia and New Zealand? A systematic review and meta-analysis. Health Promot J Austr 2022; 33 Suppl 1:278-315. [PMID: 35263481 PMCID: PMC9790538 DOI: 10.1002/hpja.592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/25/2021] [Revised: 01/18/2022] [Accepted: 02/24/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND An international systematic review concluded that individuals with poor social health (social isolation, lack of social support or loneliness) are 30% more likely to develop coronary heart disease (CHD) and stroke. Notably, the two included Australian papers reported no association between social health and CHD or stroke. OBJECTIVE We undertook a systematic review and meta-analysis to investigate the association between social isolation, lack of social support and loneliness and cardiovascular disease (CVD) incidence among people living in Australia and New Zealand. METHODS Four electronic databases were systematically searched for longitudinal studies published until June 2020. Two reviewers undertook title/abstract screen and one reviewer undertook full-text screen and data extraction. Quality was assessed using the Newcastle - Ottawa Quality Assessment Scale. RESULTS Of the 725 unique records retrieved, five papers met our inclusion criteria. These papers reported data from three Australian longitudinal datasets, with a total of 2137 CHD and 590 stroke events recorded over follow-up periods ranging from 3 to 16 years. Reports of two CHD and two stroke outcomes were suitable for meta-analysis. The included papers reported no association between social health and incidence of CVD in all fully adjusted models and most unadjusted models. CONCLUSIONS Our systematic review is inconclusive as it identified only a few studies, which relied heavily on self-reported CVD. Further studies using medical diagnosis of CVD, and assessing the potential influence of residential remoteness, are needed to better understand the relationship between social health and CVD incidence in Australia and New Zealand.
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Affiliation(s)
- Rosanne Freak‐Poli
- Department of Epidemiology and Preventive MedicineSchool of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia
| | - Aung Zaw Zaw Phyo
- Department of Epidemiology and Preventive MedicineSchool of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia
| | - Jessie Hu
- Department of Epidemiology and Preventive MedicineSchool of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia
| | - S. Fiona Barker
- Department of Epidemiology and Preventive MedicineSchool of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia
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Lee TW, Chung J, Song K, Kim E. Incidence and predictors of multimorbidity among older adults in Korea: a 10-year cohort study. BMC Geriatr 2022; 22:565. [PMID: 35799103 PMCID: PMC9264523 DOI: 10.1186/s12877-022-03250-w] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the rapid growth of the older adult population, multimorbidity has become a global concern for an aging society. Multimorbidity has been associated with poor health outcomes, including low quality of life and a high risk of mortality, resulting in an overload of healthcare systems. However, multimorbidity incidence and its related factors are poorly understood among older adults. This study aimed to determine whether sociodemographic characteristics, lifestyle, and psychosocial factors predict multimorbidity incidence among older adults in Korea. METHODS This longitudinal study used the Korean Longitudinal Study of Aging (KLoSA) dataset from 2008 to 2018. The KLoSA is a panel survey of nationally representative samples aimed at providing data for developing socioeconomic policies for the increasing aging population in Korea. The study sample included 1967 older adults aged 65 years and over who had none or one of the chronic diseases at the baseline in 2008. Multimorbidity incidence was defined as the co-existence of two or more chronic diseases among 12 doctor-diagnosed diseases based on self-reports. Cox's proportional hazards models were used to identify significant predictors of multimorbidity incidence over a 10-year follow-up period. RESULTS Among 1967 respondents (female 54.5%, mean age 72.94), 625 (31.8%) incidents of multimorbidity were reported, contributing to 47.5 incidents per 1000 people after 10 years of follow-up. Low levels of social interaction, obesity, past smoking habits, and current or past drinking habits were identified as significant predictors of multimorbidity incidence among older adults in Korea. CONCLUSIONS This study identified older adults at high risk for multimorbidity incidence. These groups require more attention from health care providers in the course of chronic disease monitoring and management. Specific interventions and health policies to promote social interaction and a healthy lifestyle are essential to delay multimorbidity incidence. This longitudinal approach will contribute to developing preventive strategies to reduce the incidence of multimorbidity among older adults.
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Affiliation(s)
- Tae Wha Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Jane Chung
- School of Nursing, Virginia Commonwealth University, Virginia, USA
| | - Kijun Song
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Eunkyung Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea.
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Lay-Yee R, Milne BJ, Wright-St Clair VA, Broad J, Wilkinson T, Connolly M, Teh R, Hayman K, Muru-Lanning M, Kerse N. Prevalence of loneliness and its association with general and health-related measures of subjective well-being in a longitudinal bicultural cohort of older adults in advanced age living in New Zealand: LiLACS NZ. J Gerontol B Psychol Sci Soc Sci 2022; 77:1904-1915. [PMID: 35767846 PMCID: PMC9535776 DOI: 10.1093/geronb/gbac087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES There is evidence that loneliness is detrimental to the subjective well-being of older adults. However, little is known on this topic for the cohort of those in advanced age (80 years or over) which today is the fastest growing age group in the New Zealand population. We examined the relationships between loneliness and selected subjective well-being outcomes over five years. METHODS We used a regional, bicultural sample of those in advanced age from 2010 to 2015 (LiLACS NZ). The first wave enrolled 937 people (92% of whom were living in the community): 421 Māori (Indigenous New Zealanders aged 80-90 years) and 516 non-Māori aged 85 years. We applied standard regression techniques to baseline data and mixed effects models to longitudinal data, while adjusting for socio-demographic factors. RESULTS For both Māori and non-Māori, strong negative associations between loneliness and subjective well-being were found at baseline. In longitudinal analyses, we found that loneliness was negatively associated with life satisfaction as well as with mental health-related quality of life. DISCUSSION Our findings of adverse impacts on subjective well-being corroborate other evidence, highlighting loneliness as a prime candidate for intervention - appropriate to cultural context - to improve well-being for adults in advanced age.
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Affiliation(s)
- Roy Lay-Yee
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), School of Social Sciences, Faculty of Arts, University of Auckland, New Zealand
| | - Barry J Milne
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), School of Social Sciences, Faculty of Arts, University of Auckland, New Zealand.,Department of Statistics, Faculty of Science, University of Auckland, New Zealand
| | | | - Joanna Broad
- Freemasons Department of Geriatric Medicine, School of Medicine, University of Auckland, New Zealand
| | - Tim Wilkinson
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Martin Connolly
- Department of Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Ruth Teh
- Department of General Practice & Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Karen Hayman
- Department of General Practice & Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | | | - Ngaire Kerse
- Department of General Practice & Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
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Jayakody DMP, Wishart J, Stegeman I, Eikelboom R, Moyle TC, Yiannos JM, Goodman-Simpson JJ, Almeida OP. Is There an Association Between Untreated Hearing Loss and Psychosocial Outcomes? Front Aging Neurosci 2022; 14:868673. [PMID: 35663574 PMCID: PMC9162786 DOI: 10.3389/fnagi.2022.868673] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/13/2022] [Indexed: 12/20/2022] Open
Abstract
Objective Age-related hearing loss is one of the leading causes of disability in older adults. This cross-sectional study investigated the association between untreated hearing loss, social (perception of quality and quantity of social network) and emotional loneliness (perception of limited emotional support), social isolation (size of the social network), social support (actual or perceived availability of resources from the social network) and psychological discomfort (depression, anxiety, and stress) in older adults. Study Design Cross-sectional study design. Methods A total of 202 community derived sample of volunteers, age range 40-89 years, mean age (M) = 65.3 ± 11.0 years were recruited. Of these 115 were females (M = 63.2 ± 12.0 years) and 87 were males (M = 68.2 ± 8.9 years). All participants completed a hearing assessment, social interaction and support questionnaire and a social and emotional loneliness questionnaire. Results Hearing loss significantly contributed to both moderate [P < 0.001, B (95% CI): 0.01 (0.99-1.02)] and intense levels [P < 0.001, 0.02 (1.00-1.04)] of emotional loneliness. Depression was significantly associated with satisfaction with social support [P < 0.001; -0.17 (-0.23 to -0.11), social interaction [P = 0.01; -0.07 (-0.12 to -0.01)], and moderate [P < 0.001; 0.31 (1.22-1.53)] and intense [P < 0.001; 0.29 (1.20-1.50)] levels of emotional loneliness and intense levels of social loneliness [P = 0.01; 0.12 (1.05-1.21)]. Conclusion Untreated hearing loss significantly increases the odds of being emotionally lonely. Depression significantly contributes to social and emotional loneliness, satisfaction with social support and social loneliness. Given the higher prevalence of loneliness and psychological discomfort and their associations with untreated hearing loss, hearing-impaired older adults are at significant risk of developing loneliness and psychological discomfort. Therefore, hearing health professionals should be aware of the psychosocial burden that may accompany hearing loss, in order to provide appropriate advice and support.
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Affiliation(s)
- Dona M. P. Jayakody
- Ear Science Institute Australia, Subiaco, WA, Australia
- Ear Sciences Centre, Medical School, University of Western Australia, Perth, WA, Australia
- Centre for Health and Ageing, University of Western Australia, Perth, WA, Australia
| | - Justin Wishart
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Macquarie University, Sydney, NSW, Australia
| | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Robert Eikelboom
- Ear Science Institute Australia, Subiaco, WA, Australia
- Ear Sciences Centre, Medical School, University of Western Australia, Perth, WA, Australia
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Thomas C. Moyle
- Department of Physics, Faculty of Engineering, Mathematics and Sciences, University of Western Australia, Perth, WA, Australia
| | | | | | - Osvaldo P. Almeida
- Centre for Health and Ageing, University of Western Australia, Perth, WA, Australia
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Freak-Poli R, Kung CSJ, Ryan J, Shields MA. Social Isolation, Social Support, and Loneliness Profiles Before and After Spousal Death and the Buffering Role of Financial Resources. J Gerontol B Psychol Sci Soc Sci 2022; 77:956-971. [PMID: 35373252 PMCID: PMC9071412 DOI: 10.1093/geronb/gbac039] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives We provide new evidence on the profiles of social isolation, social support, and loneliness before and after spousal death for older widows. We also examine the moderating effects of gender and financial resources on changes in social health before and after widowhood. Methods We use 19 waves of data from the Household, Income and Labour Dynamics in Australia Survey, including 749 widowed individuals and a comparison group of around 8,000 married individuals. We apply coarsened exact matching weights and control for age and time trends. Local polynomial smoothed plots show the profiles of social health from 3 years pre- to 3 years postspousal death. All analyses were stratified by gender. Results Spousal death was strongly associated with increased loneliness for women and men, but also an increase in interactions with friends and family not living with the bereaved. For men, financial resources (both income and asset wealth) provided some protection against loneliness. Spousal death was not associated with changes in social support or participation in community activities. Discussion We demonstrate that loneliness is a greater challenge of widowhood than social isolation or a lack of social support. Our findings suggest that interventions focusing only on increasing social interactions are unlikely to alleviate loneliness following spousal death. Moreover, policies that reduce the cost of formal social participation may have limited effectiveness in tackling loneliness, particularly for women. Alternative strategies, such as helping the bereaved form a new sense of identity and screening for loneliness around widowhood by health care workers, could be beneficial.
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Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Claryn S J Kung
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael A Shields
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia
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Freak-Poli R, Ryan J, Neumann JT, Tonkin A, Reid CM, Woods RL, Nelson M, Stocks N, Berk M, McNeil JJ, Britt C, Owen AJ. Social isolation, social support and loneliness as predictors of cardiovascular disease incidence and mortality. BMC Geriatr 2021; 21:711. [PMID: 34922471 PMCID: PMC8684069 DOI: 10.1186/s12877-021-02602-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 04/21/2021] [Accepted: 10/18/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Poor social health is associated with increased risk of cardiovascular disease (CVD). Recent research suggests that different social health domains should be considered separately as the implications for health and possible interventions may differ. AIM To assess social isolation, low social support and loneliness as predictors of CVD. METHODS Secondary analysis of 11,486 community-dwelling, Australians, aged 70 years and over, free of CVD, dementia, or significant physical disability, from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. Social isolation, social support (Revised Lubben Social Network Scale), and loneliness were assessed as predictors of CVD using Cox proportional-hazard regression. CVD events included fatal CVD, heart failure hospitalization, myocardial infarction and stroke. Analyses were adjusted for established CVD risk factors. RESULTS Individuals with poor social health were 42 % more likely to develop CVD (p = 0.01) and twice as likely to die from CVD (p = 0.02) over a median 4.5 years follow-up. Interaction effects indicated that poorer social health more strongly predicted CVD in smokers (HR 4.83, p = 0.001, p-interaction = 0.01), major city dwellers (HR 1.94, p < 0.001, p-interaction=0.03), and younger older adults (70-75 years; HR 2.12, p < 0.001, p-interaction = 0.01). Social isolation (HR 1.66, p = 0.04) and low social support (HR 2.05, p = 0.002), but not loneliness (HR 1.4, p = 0.1), predicted incident CVD. All measures of poor social health predicted ischemic stroke (HR 1.73 to 3.16). CONCLUSIONS Among healthy older adults, social isolation and low social support may be more important than loneliness as cardiovascular risk factors. Social health domains should be considered in future CVD risk prediction models.
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Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Johannes T. Neumann
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel, Lübeck, Germany
| | - Andrew Tonkin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Christopher M. Reid
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
- School of Public Health, Curtin University, 6102 Perth, WA Australia
| | - Robyn L. Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Mark Nelson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
- Menzies Institute for Medical Research, University of Tasmania, 7000 Hobart, TAS Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, 5005 Adelaide, SA Australia
| | - Michael Berk
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
- IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Department of Psychiatry, Florey Institute for Neuroscience and Centre for Mental Health, University of Melbourne, Parkville, Victoria Australia
| | - John J. McNeil
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Carlene Britt
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Alice J. Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
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Joyce J, Ryan J, Owen A, Hu J, Power JM, Shah R, Woods R, Storey E, Britt C, Freak-Poli R. Social isolation, social support, and loneliness and their relationship with cognitive health and dementia. Int J Geriatr Psychiatry 2021; 37:10.1002/gps.5644. [PMID: 34741340 PMCID: PMC9068834 DOI: 10.1002/gps.5644] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/31/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Poor social health is prevalent in older adults and may be associated with worse cognition, and increased dementia risk. The aim of this study was to determine whether social isolation, social support and loneliness are independently associated with cognitive function and incident dementia over 5 years in older adults, and to investigate potential gender differences. METHODS Participants were 11,498 community-dwelling relatively healthy Australians aged 70-94, in the ASPREE Longitudinal Study of Older Persons (ALSOP). Social isolation, social support, loneliness and cognitive function were assessed through self-report. Outcomes examined were cognitive decline (>1.5 SD decline in cognitive performance since baseline) and incident dementia (adjudicated according to DSM-IV criteria). RESULTS Most participants self-reported good social health (92%) with very few socially isolated (2%), with low social support (2%) or lonely (5%). Among women, social isolation and low social support were consistently associated with lower cognitive function (e.g., social support and cognition β = -1.17, p < 0.001). No consistent longitudinal associations were observed between baseline social health and cognitive decline (over median 3.1 years) or incident dementia (over median 4.4 years; social isolation: HR = 1.00, p = 0.99; low social support: HR = 1.79, p = 0.11; loneliness: HR = 0.72, p = 0.34 among women and men). CONCLUSION Our study provides evidence that social isolation and a low social support are associated with worse cognitive function in women, but not men. Social health did not predict incident cognitive decline or dementia, but we lacked power to stratify dementia analyses by gender.
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Affiliation(s)
- Johanna Joyce
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Jessie Hu
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Raj Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Robyn Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Elsdon Storey
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Carlene Britt
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
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Umstattd Meyer MR, Prochnow T, Pickett AC, Perry CK, Bridges Hamilton CN, Abildso CG, Pollack Porter KM. The Effects of Play Streets on Social and Community Connectedness in Rural Communities. Int J Environ Res Public Health 2021; 18:9976. [PMID: 34639278 PMCID: PMC8508026 DOI: 10.3390/ijerph18199976] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
Promoting physical activity (PA) is a long-standing public health initiative to improve overall health and wellbeing. Innovative strategies such as Play Streets, temporary activation of public spaces to provide safe places for active play, are being adopted in urban and rural communities to increase PA among children. As part of these strategies, aspects of social and community connectedness may be strengthened. This study analyzes focus groups and interviews from rural Play Street implementation team members (n = 14) as well as adults (n = 7) and children (n = 25) who attended Play Streets hosted in rural North Carolina, Maryland, Oklahoma, and Texas to better understand the added benefits of Play Streets in community connectedness. Overall, elements of social support and social cohesion are mentioned most frequently with instrumental and conditional support; however, concepts of social capital, collective-efficacy, and social identification are also presented. Participants expressed that Play Streets provided more than just PA; they provided opportunities to access and share resources, build perceptions of safety and trust in the community, and develop relationships with others. Fostering community connection through Play Streets may reduce health inequities in rural communities by building community resilience. Community-based PA programming that enhance and capitalize on community connectedness could be effective ways to improving the overall health and wellbeing of residents.
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Affiliation(s)
- M. Renée Umstattd Meyer
- Department of Public Health, Baylor University Robbins College of Health and Human Sciences, Waco, TX 78628, USA; (T.P.); (C.N.B.H.)
| | - Tyler Prochnow
- Department of Public Health, Baylor University Robbins College of Health and Human Sciences, Waco, TX 78628, USA; (T.P.); (C.N.B.H.)
- Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843, USA
| | - Andrew C. Pickett
- Division of Kinesiology & Sport Management, School of Education Research Center, University of South Dakota, Vermillion, SD 57069, USA;
| | - Cynthia K. Perry
- School of Nursing, Oregon Health & Science University, Portland, OR 97239, USA;
| | - Christina N. Bridges Hamilton
- Department of Public Health, Baylor University Robbins College of Health and Human Sciences, Waco, TX 78628, USA; (T.P.); (C.N.B.H.)
- Department of Public Health & Health Education, SUNY Brockport, Brockport, NY 14420, USA
| | - Christiaan G. Abildso
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV 25606, USA;
| | - Keshia M. Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
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