Association between social isolation and outpatient follow-up in older adults following emergency department discharge

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

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Follow-up trends after Emergency Department discharge for acutely symptomatic hernias

The American Journal of Surgery ◽

10.1016/j.amjsurg.2017.08.028 ◽

2017 ◽

Vol 214 (6) ◽

pp. 1018-1021 ◽

Cited By ~ 2

Author(s):

Lara Spence ◽

Eric Pillado ◽

Dennis Kim ◽

David Plurad

Keyword(s):

Emergency Department ◽

Emergency Department Discharge

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Ambulatory Follow-up and Outcomes Among Medicare Beneficiaries After Emergency Department Discharge

JAMA Network Open ◽

10.1001/jamanetworkopen.2020.19878 ◽

2020 ◽

Vol 3 (10) ◽

pp. e2019878

Author(s):

Michelle P. Lin ◽

Ryan C. Burke ◽

E. John Orav ◽

Tynan H. Friend ◽

Laura G. Burke

Keyword(s):

Emergency Department ◽

Medicare Beneficiaries ◽

Emergency Department Discharge

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Improving Outpatient Follow-Up Through Innovative Appointment Scheduling at Emergency Department Discharge

Advanced Emergency Nursing Journal ◽

10.1097/tme.0000000000000340 ◽

2021 ◽

Vol 43 (1) ◽

pp. 71-78

Author(s):

Ashley Tessitore ◽

Jill Brennan-Cook

Keyword(s):

Emergency Department ◽

Appointment Scheduling ◽

Emergency Department Discharge

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283 Automated Follow-Up Text Messages to Identify Unmet Needs at Emergency Department Discharge: A Pilot Study

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2019.08.241 ◽

2019 ◽

Vol 74 (4) ◽

pp. S112

Author(s):

G. Fuller ◽

S. Tat ◽

I. Green-Hopkins

Keyword(s):

Emergency Department ◽

Pilot Study ◽

Unmet Needs ◽

Text Messages ◽

Emergency Department Discharge

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Tele-Follow-Up of Older Adult Patients from the Geriatric Emergency Department Innovation (GEDI) Program

Geriatrics ◽

10.3390/geriatrics4010018 ◽

2019 ◽

Vol 4 (1) ◽

pp. 18 ◽

Cited By ~ 4

Author(s):

Lucy Morse ◽

Linda Xiong ◽

Vanessa Ramirez-Zohfeld ◽

Scott Dresden ◽

Lee Lindquist

Keyword(s):

Older Adults ◽

Emergency Department ◽

Social Services ◽

Care Coordination ◽

Symptom Management ◽

Comparative Method ◽

Patient Needs ◽

Time Points ◽

Phone Calls

The objective of this study was to characterize the content and interventions performed during follow-up phone calls made to patients discharged from the Geriatrics Emergency Department Innovation (GEDI) Program and to demonstrate the benefit of these calls in the care of older adults discharged from the emergency department (ED). This study utilizes retrospective chart review with qualitative analysis. It was set in a large, urban, academic hospital emergency department utilizing the Geriatric Emergency Department Innovations (GEDI) Program. The subjects were adults aged 65 and over who visited the emergency department for acute care. Follow-up telephone calls were made by geriatric nurse liaisons (GNLs) at 24–72 h and 10–14 days post-discharge from the ED. The GNLs documented the content of the phone calls, and these notes were analyzed through a constant comparative method to identify emergent themes. The results showed that the most commonly arising themes in the patients’ questions and nurses’ responses across time-points included symptom management, medications, and care coordination (physician appointments, social services, therapy, and medical equipment). Early follow-up presented the opportunity for nurses to address needs in symptom management and care coordination that directly related to the ED admission; later follow-up presented a unique opportunity to resolve sub-acute issues that were not addressed by the initial discharge plan and to manage newly arising symptoms and patient needs. Thus, telephone follow-up after emergency department discharge presents an opportunity to better connect older adults with appropriate outpatient care and to address needs arising shortly after discharge that may not have otherwise been detected. By following up at two discrete time-points, this intervention identifies and addresses distinct patient needs.

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Are Loneliness and Social Isolation Associated with Quality of Life in Older Adults? Insights from Northern and Southern Europe

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228637 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8637

Author(s):

Giorgi Beridze ◽

Alba Ayala ◽

Oscar Ribeiro ◽

Gloria Fernández-Mayoralas ◽

Carmen Rodríguez-Blázquez ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Standard Deviation ◽

Social Isolation ◽

Standard Deviation Increase ◽

The North ◽

Health Aging ◽

Context Specific

Purpose: Loneliness and social isolation have detrimental effects on health in old age; however, the prospective associations with quality of life (QoL) remain unclear. Furthermore, despite the existence of a European north-south gradient in the distribution of loneliness and social isolation, little is known whether the associations are context-specific. We investigated the relationships between loneliness, social isolation and QoL of older adults residing in the North (Sweden) and South (Spain) of Europe. Methods: Study sample consisted of 2995 Swedish and 4154 Spanish older adults who participated in waves six and seven of the Study on Health, Aging and Retirement in Europe (SHARE). Loneliness and social isolation were measured at the baseline, and QoL was measured at the baseline and follow-up using CASP-12. Prospective associations were assessed via multivariate linear regression. Results: In Sweden, subjects with higher vs. lower loneliness had 1.01 (95% CI: −1.55, −0.40) units lower QoL, while every standard deviation increase in social isolation was associated with a 0.27 (95% CI: −0.42, −0.09)-unit decrease in QoL. In Spain, every standard deviation increase in social isolation was associated with a 0.66 (95% CI: −1.11, −0.22)-unit decrease in QoL. The association was stronger in subjects aged ≤65 years old and those with no chronic diseases. The association with loneliness was not statistically significant in Spain. Conclusion: Loneliness and social isolation are prospectively associated with decreased QoL among older adults, yet the associations are contextually bound. Future interventions should target both exposures, among others, in order to increase QoL in this group.

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