Reducing Loneliness Among Aging Adults: The Roles of Personal Voice Assistants and Anthropomorphic Interactions

The perception of feeling lonely is an influential factor in determining quality of life among aging adults. As the US Census Bureau projects that the number of Americans ages 65 and older will double by 2060, reducing loneliness is imperative. Personal voice assistants (PVAs) such as Amazon's Echo offer the ease-of-use of voice control with a friendly, helpful artificial intelligence. This study aimed to understand the influence of a PVA on loneliness reduction among adults of advanced ages, i.e., 75+, and explore anthropomorphism as a potential underlying mechanism. Participants (N = 16) ages 75 or older used an Amazon Echo PVA for 8 weeks in an independent living facility in the Midwest. Surveys were used to collect information about perceived loneliness, and PVA interaction data was recorded and analyzed. Participants consistently exceeded the required daily interactions. As hypothesized, after the first 4 weeks of the intervention, aging adults reported significantly lower loneliness (baseline mean = 2.22, SD = 0.42; week 4 mean = 1.99, SD = 0.45, Z = −2.45, and p = 0.01). Four dominant anthropomorphic themes emerged after thematic analysis of the entire 8 weeks' PVA interaction data (Cohen's Kappa = 0.92): (1) greetings (user-initiated, friendly phrases); (2) comments/questions (user-initiated, second-person pronoun), (3) polite interactions (user-initiated, direct-name friendly requests), (4) reaction (user response to Alexa). Relational greetings predicted loneliness reductions in the first 4 weeks and baseline loneliness predicted relational greetings with the PVA during the entire 8 weeks, suggesting that anthropomorphization of PVAs may play a role in mitigating loneliness in aging adults.

Vision Difficulty and Engagement in Care Among Aging Men Living With HIV

For aging adults living with HIV (AALH) who have complex medical care needs, vision impairment may be an added burden that may lead individuals to disengage from their own medical care. We examined the relationships of self-reported vision difficulty with indicators of care engagement: 1) adherence to HIV antiretroviral therapy (ART; defined as taking ≥95% of medications); 2) self-reported avoidance of medical care; 3) self-reported tendency to ask a doctor questions about care (> 2 questions at a medical visit). A modified version of the National Eye Institute vision function questionnaire was administered at three semi-annual visits (from October 2017 to April 2018) to assess difficulty performing vision-dependent tasks (no, a little, moderate to extreme difficulty). We included 1063 AALH participants (median age 60 years, 24% Black). Data were analyzed using repeated measures logistic regression with generalized estimating equations adjusted for fixed race, and at visit values for age, education level, depressive symptoms, alcohol use, and smoking status. Compared to no vision difficulty, those reporting moderate to extreme vision difficulty on at least one task (18%) had 1.95 times higher odds (95% CI: 1.36, 2.79) of having less than optimal ART adherence and 1.92 times higher odds [95% CI: 1.06, 3.47]) of avoiding necessary medical care, but 1.6 times higher odds [95%CI: 0.93, 2.72] of asking more questions. These findings suggest that vision impairment plays a role in medical care engagement among older adults living with HIV, and may contribute to poorer management of HIV and chronic comorbidities.

Depressive Symptoms Mediate the Influence of Fibromyalgia Status on Physical Performance and BMI in Aging Adults

Fibromyalgia is a chronic pain condition that is frequently accompanied by comorbid conditions, including depression. Depression is associated with reduced physical functioning and health disproportionately affecting middle-aged and older adults with fibromyalgia. This study examined depressive symptoms as a mechanism through which FM status is associated with BMI and physical performance among adults in mid-to-late-life. Participants included 250 community-dwelling middle-aged and older adults (82% female) with (59%) or without (41%) fibromyalgia (M age = 64.44, SD = 9.16). Depressive symptoms were measured using the Beck Depression Inventory-II, BMI was objectively assessed, and physical performance was measured using the Fullerton Advanced Balance scale, 6-Minute Walk Test, 30-Second Chair Stand, and 8-Foot Up and Go Test. Physical performance measure analyses were adjusted for age. Asymptotic mediation analyses revealed that fibromyalgia status was indirectly associated with higher BMI (95% CI [.18, 16.74]), and poorer performance in the Fullerton Advanced Balance (CI [-2.93, -1.24]), 6-Minute Walk Test (CI [-73.75, -35.35]), 30-Second Chair Stand (CI [-2.45, -1.16]), and 8-Foot Up and Go test (CI [.35, .92]) via depressive symptoms. Participants with fibromyalgia reported greater depressive symptoms which was subsequently associated with greater BMI and reduced physical performance. Findings support depressive symptoms as one factor through which fibromyalgia status is associated with higher obesity risk and reduced physical function in middle-aged and older adults with fibromyalgia. This study supports fibromyalgia status as a critical consideration when evaluating the health and disability risk of aging adults.