Determinants of social inclusion and their effect on the wellbeing of older adults

Abstract Social inclusion fosters interpersonal relationships that reduce social isolation and enhance wellbeing in older adults. This study finds that socially engaged older adults are less likely to decline in health and have more wellbeing than those less engaged. The connection between wellbeing and social engagement is examined with hypotheses that there is a significant linear relationship between wellbeing and age, ethnicity, gender, the involvement and perception of participatory activities, community dwelling and the use of technology among older adults. A multiple linear regression on 4621samples obtained from National Health and Aging Trend Study, Round 8 shows that social engagement explained a unique variance in wellbeing (34.5%) suggesting that more social connections, via social activities, community-dwelling, mobility, and use of technology, there is enhanced health and fewer chances of cognitive decline in older adults. The use of text messaging and emails had a moderating effect on cognition and wellbeing of older adults. It is suggested that existing low-cost community programs targeting the so-called social determinants of health can be reworked to address social isolation and foster knowledge and technology skills in the older population. Directions for future research include examining human behaviors and perceptions to stay connected.

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Validation of a Measure of Loneliness for Homebound Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.2367 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 624-624

Author(s):

Keith Chan ◽

Christina Marsack-Topolewski ◽

Sarah LaFave ◽

Maggie Ratnayake ◽

Jillian Graves ◽

...

Keyword(s):

Older Adults ◽

Social Isolation ◽

Reliability And Validity ◽

Community Dwelling ◽

Future Research ◽

Factor Analyses ◽

Confirmatory Factor Analyses ◽

Loneliness Scale ◽

Confirmatory Factor ◽

Homebound Older Adults

Abstract The pandemic has disproportionately impacted older adults, highlighting the need to address social isolation for this population. Homebound older adults are at risk for loneliness, which is a correlate of poor mental and physical health. COVID-19 has exacerbated effects of social isolation by limiting contact with family and other visitors. In-depth empirical validation of loneliness scales is needed to examine the measurement of this construct for homebound older adults who are aging in place. This study examined the reliability and validity of the UCLA Loneliness Scale (v3) for a community-dwelling population of older adults who received home-based support services due to their homebound status or have chronic illness resulting in ADL limitations. Using in-home interviews, data were collected for 175 older adults using the UCLA Loneliness Scale. Reliability and confirmatory factor analyses were conducted to examine its psychometric properties. Findings demonstrated the scale had good internal consistency reliability (ɑ = 0.91). Confirmatory factor analyses indicated a two-factor solution, 1) disconnectedness and 2) connectedness, accounting for 92% of the variability in the 20 items. The lack of meaningful relationships (ƛ = 0.73, p < 0.05) or having someone to turn to (ƛ = 0.68, p < 0.05) substantively contributed to disconnectedness. Feeling that there were people to talk to (ƛ = 0.67, p < 0.05) and turn to (ƛ = 0.76, p < 0.05) contributed to connectedness. Future research can further examine how quality of relationships and benefits of being connected to others can address loneliness and isolation for this population.

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Qualitative Research on the Primary Effect of Fish Pet Ownership Using the Bottleium, a Bottle-Type Aquarium, on Community-Dwelling Older Adults in Japan: A Potential Preventive Measure Towards Social Isolation

Geriatrics ◽

10.3390/geriatrics6010017 ◽

2021 ◽

Vol 6 (1) ◽

pp. 17

Author(s):

Mai Takase ◽

Ryogo Ogino ◽

Keishiro Yoshida ◽

Hikari Kusu ◽

Tetsuya Kenmochi ◽

...

Keyword(s):

Older Adults ◽

Social Isolation ◽

Social Inclusion ◽

Preventive Measure ◽

Community Dwelling ◽

Human Interaction ◽

Psychological State ◽

Pet Ownership ◽

Suitable Alternative ◽

Community Dwelling Older Adults

Aging increases the risk of social isolation, which could lead to conditions such as depressive mood. Pet ownership is known to reduce social isolation. However, previous studies have mainly focused on mammals as pets, which could be difficult at old age. A small ornamental fish is relatively easy to culture and might be a suitable alternative. In this research, we aimed to elucidate the possible effects of fish ownership on the psychological state of community-dwelling older adults in Japan. A Bottleium, a bottle-type aquarium, was selected to lower the burden of fish ownership. A workshop was hosted in 2019 and participants brought home their own Bottleium, with fish and water snail inside. Nineteen participants gave consent to the follow-up interview a month later. Five themes, “observation of fish and water snail,” “interaction between the fish and the owner,” “taking care of the fish as pet owner,” “facilitation of interpersonal interaction,” and “development of support system,” emerged from thematic analysis. The promotion of animal-to-human, and human-to-human interaction and development of responsibility could relate to a sense of social inclusion and ikigai-kan, a purpose of life. Fish ownership, when using equipment that suits the physical capability of older adults, could act as a positive stimulus.

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Is Sedentary Behavior or Physical Activity Associated With Loneliness in Older Adults? Results of the European-Wide SITLESS Study

Journal of Aging and Physical Activity ◽

10.1123/japa.2019-0311 ◽

2020 ◽

Vol 28 (4) ◽

pp. 549-555 ◽

Cited By ~ 2

Author(s):

Mark A. Tully ◽

Ilona I. McMullan ◽

Nicole E. Blackburn ◽

Jason J. Wilson ◽

Laura Coll-Planas ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sedentary Behavior ◽

Social Isolation ◽

Living Arrangements ◽

Social Engagement ◽

Well Being ◽

Educational Background ◽

Community Dwelling ◽

Objectively Measured

Research has found that social relationships are central to the health and well-being of an aging population. Evidence exploring the association between physical activity (PA) and sedentary behavior (SB) with social isolation and loneliness is limited. This study uses objectively measured PA and SB (ActiGraph®) and self-reported measures of loneliness (the De Jong Gierveld Loneliness Scale) and social engagement (the Lubben Social Network Scale) from the SITLESS study, a European-wide study of community-dwelling older adults. Social isolation was associated with SB where higher levels of SB were associated with an increase in the level of social isolation, controlling for age, sex, living arrangements, employment status, body mass index, educational background, marital status, and self-reported general health. In contrast, PA was not associated with social isolation, and neither SB nor PA was a statistically significant predictor of loneliness. SB may be linked to social isolation in older adults, but PA and SB are not necessarily linked to loneliness in older community-dwelling adults.

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The Relationship between Social Isolation and Sense of Community among Older Adults in Puerto Rico

Innovation in Aging ◽

10.1093/geroni/igab046.3168 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 876-877

Author(s):

Thomas Buckley ◽

Denise Burnette

Keyword(s):

Older Adults ◽

Puerto Rico ◽

Social Isolation ◽

Latin American ◽

Sense Of Community ◽

Living Arrangement ◽

Community Dwelling ◽

Future Research ◽

Spanish Translation ◽

Cross Sectional

Abstract Psychological sense of community (SOC) is linked to key health and wellbeing outcomes for older adults and among Latin American populations. Prior research shows that social factors may affect SOC, but this has yet to be studied among Puerto Rican older adults. This study draws on Social Resource Theory to test the hypothesis that social isolation is associated with SOC among older adults in Puerto Rico. We collected data through face-to-face interviews in a non-probability sample of community dwelling adults aged 60+ throughout Puerto Rico in 2019-2020 (N = 154). We measured social isolation with the Spanish translation of the LSNS-6 (range 0-30, mean= 14.00, SD= 5.99), where higher scores indicate less isolation, and SOC with the Spanish translation of the Brief Sense of Community Scale (range 0-32, mean= 24.75, SD= 6.04). This cross-sectional study used multiple linear regression to test the association between social isolation and SOC, while controlling for gender, age, income and living arrangement. Higher scores on the LSNS-6 were associated with higher SOC (β=0.31, SE=0.08, p<0.001). Among the sociodemographic covariates, increased age was associated with higher SOC (β=0.12, SE=0.05, p<0.05). This study demonstrates that older adults in Puerto Rico who are more socially isolated have lower SOC, and that SOC increases with age. In order to promote SOC in this population, interventions should focus on reducing social isolation and may benefit from targeting young-old older adults. Future research should continue to examine these relationships and extend to other Latin American cultures.

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The Validity of Consumer-Level Activity Monitors in Healthy Older Adults in Free-Living Conditions

Journal of Aging and Physical Activity ◽

10.1123/japa.2016-0344 ◽

2018 ◽

Vol 26 (1) ◽

pp. 128-135 ◽

Cited By ~ 22

Author(s):

Nicolas Farina ◽

Ruth G. Lowry

Keyword(s):

Older Adults ◽

Low Cost ◽

Living Conditions ◽

Community Dwelling ◽

Future Research ◽

Free Living ◽

Activity Monitors ◽

And Function ◽

Healthy Community ◽

Free Living Conditions

Consumer-level activity monitors, such as Fitbit and Misfit devices, are a popular and low-cost means of measuring physical activity. This study aims to compare the accuracy of step counts from two consumer-level activity monitors against two reference devices in healthy, community-dwelling older adults in free-living conditions. Twenty-five older adults (aged 65–84) simultaneously wore 5 devices (e.g., Misfit Shine and Fitbit Charge HR) over 7 consecutive days. All consumer-level activity monitors positively correlated with reference devices (p < .001). There was also substantial to near perfect agreement between all consumer-level activity monitors and reference devices. Compared to the ActiGraph GT3X+, the waist-worn Misfit Shine displayed the highest agreement amongst the devices worn (ICC = 0.96, 95% 0.91 to 0.99). The wrist-worn devices showed poorer agreement to reference devices. Future research needs to consider that not all consumer-level activity monitors are equal in terms of accuracy, design, and function.

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Loneliness During COVID-19 and Modes of Social Contact Use Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.2743 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 744-744

Author(s):

Usha Dhakal ◽

Athena Koumoutzis

Keyword(s):

Older Adults ◽

Social Engagement ◽

Social Connectedness ◽

Social Contact ◽

Network Size ◽

Community Dwelling ◽

Medicare Beneficiaries ◽

Multinomial Regression ◽

Social Network Size ◽

Use Of Technology

Abstract Due to social distancing and isolation recommendations, COVID-19 resulted in older adults’ greater reliance on technology to contact friends and families. While the mental health of older adults during COVID-19 has been well explored, less is known about how changes in modes and frequency of social contact is associated with loneliness. Using the National Health and Aging Trends Study COVID-19 data, this study assessed how the frequency of varying modes of contact (e.g., phone/email/text, in-person visits, videocalls) during the pandemic was associated with feelings of loneliness during COVID-19 among community-dwelling Medicare beneficiaries (n = 2149). Participants were asked if they felt lonely “more often,” “less often,” or “about the same” compared to before the outbreak started. Multinomial regression analyses indicated that, compared to those who reported daily in-person visits, the odds of having more feelings of loneliness as compared to about the same as pre-COVID-19 was significantly higher among those who reported having in-person visits a few times (OR=2.17,CI=1.08-4.36), at least once (OR=2.37,CI=1.11-5.04), and never/less than once a week (OR=3.37, CI=1.59-7.16) while controlling for demographics, household, and social network size. Compared to daily use, use of phone/email/text at least once (OR=0.44, CI=0.201-0.965) or a few times (OR=0.76,CI=0.58-0.99) a week was associated with lower odds of reporting more feelings of loneliness versus about the same. Results suggest that greater use of technology that promote social engagement improves social connectedness and decreases COVID-19 related loneliness among older adults, and highlights the importance of older adults’ access to technology, including reliable internet.

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Perceived Voice Disorders in Older Adults and Impact on Social Interactions

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00059 ◽

2021 ◽

pp. 1-8

Author(s):

Connie K. Porcaro ◽

Clare Singer ◽

Boris Djokic ◽

Ali A. Danesh ◽

Ruth Tappen ◽

...

Keyword(s):

Older Adults ◽

Social Interactions ◽

Social Engagement ◽

Leisure Activities ◽

Treatment Strategies ◽

Voice Disorders ◽

Community Dwelling ◽

Vocal Performance ◽

Older Individuals ◽

Cross Sectional

Purpose Many aging individuals, even those who are healthy, report voice changes that can impact their ability to communicate as they once did. While this is commonly reported, most do not seek evaluation or management for this issue. The purpose of this study was to investigate the prevalence and differences in voice disorders in older adults, along with the effect of fatigue on their social interactions. Method This is a cross-sectional investigation of a community-dwelling sample of individuals aged 60 years or older. Participants completed the Questionnaire on Vocal Performance, the Social Engagement Index subset “Engagement in Social or Leisure Activities,” and the Fatigue Severity Scale. Results Results indicated 32.5% of the 332 participants reported symptoms of voice problems with no difference found between male and female respondents. A slight increase in report of voice problems was noted with each year of age. Participants who self-reported voice problems indicated less interaction in social activities involving communication than those who did not. Finally, as severity of self-reported voice problems increased, an increase was reported by the same individuals for signs of fatigue. Conclusions Voice problems and resulting decreased social interaction are commonly experienced by older individuals. Voice symptoms in older adults have been found to benefit from evidence-based treatment strategies. It is critical to provide education to encourage older individuals to seek appropriate evaluation and management for voice issues through a speech-language pathologist or medical professional.

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Brain Health: Attitudes towards Technology Adoption in Older Adults

Healthcare ◽

10.3390/healthcare9010023 ◽

2020 ◽

Vol 9 (1) ◽

pp. 23

Author(s):

Nadir G. Abdelrahman ◽

Raza Haque ◽

Molly E. Polverento ◽

Andrea Wendling ◽

Courtney M. Goetz ◽

...

Keyword(s):

Older Adults ◽

Technology Adoption ◽

Physical Health ◽

Social Engagement ◽

Information Technologies ◽

New Technology ◽

Handheld Devices ◽

Brain Health ◽

Use Of Technology ◽

Health Related

(1) Background: There is increasing scholarly support for the notion that properly implemented and used, technology can be of substantial benefit for older adults. Use of technology has been associated with improved self-rating of health and fewer chronic conditions. Use of technology such as handheld devices by older adults has the potential to improve engagement and promote cognitive and physical health. However, although, literature suggests some willingness by older adults to use technology, simultaneously there are reports of a more cautious attitude to its adoption. Our objective was to determine the opinions towards information technologies, with special reference to brain health, in healthy older adults either fully retired or still working in some capacity including older adult workers and retired adults living in an independent elderly living community. We were especially interested in further our understanding of factors that may play a role in technology adoption and its relevance to addressing health related issues in this population; (2) Methods: Two focus groups were conducted in an inner-city community. Participants were older adults with an interest in their general health and prevention of cognitive decline. They were asked to discuss their perceptions of and preferences for the use of technology. Transcripts were coded for thematic analysis; (3) Results: Seven common themes emerged from the focus group interviews: physical health, cognitive health, social engagement, organizing information, desire to learn new technology, advancing technology, and privacy/security; and (4) Conclusions: This study suggests that in order to promote the use of technology in older adults, one needs to consider wider contextual issues, not only device design per se, but the older adult’s rationale for using technology and their socio-ecological context.

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Social Engagement and Episodic Memory in Non-Hispanic Black and White Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1101 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 343-343

Author(s):

Abbey Hamlin ◽

A Zarina Kraal ◽

Laura Zahodne

Keyword(s):

Social Support ◽

Older Adults ◽

Episodic Memory ◽

Cognitive Aging ◽

Social Engagement ◽

Future Research ◽

Social Activities ◽

Linear Regression Models ◽

Significant Positive Association ◽

Cross Sectional

Abstract Social engagement may confer cognitive benefits in older adulthood, but studies have typically been restricted to largely non-Hispanic White (NHW) samples. Levels of social engagement vary across race such that NHW report larger social networks, more frequent participation in social activities, and greater social support than non-Hispanic Blacks (NHB). Associations between social engagement and cognition may also vary by race, but research is sparse. The current cross-sectional study examined associations between different aspects of social engagement and episodic memory performance, as well as interactions between social engagement and race among NHB and NHW participants in the Michigan Cognitive Aging Project (N = 247; 48.4% NHB; age = 64.19 ± 2.92). Social engagement (network size, activities, support) was self-reported. Episodic memory was a z-score composite of immediate, delayed, and recognition trials of a list-learning task. Separate hierarchical linear regression models quantified interactions between race and each of the three social engagement variables on episodic memory, controlling for sociodemographics, depressive symptoms, and health conditions. Results showed a main effect of more frequent social activity on better episodic memory, as well as an interaction between race and social support indicating a significant positive association in NHB but not NHW. These preliminary findings suggest that participating in social activities may be equally beneficial for episodic memory across NHB and NHW older adults and that social support may be particularly beneficial for NHB. Future research is needed to determine the potential applications of these results in reducing cognitive inequalities through the development of culturally-relevant interventions.

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Technology Used to Recognize Activities of Daily Living in Community-Dwelling Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010163 ◽

2020 ◽

Vol 18 (1) ◽

pp. 163

Author(s):

Nicola Camp ◽

Martin Lewis ◽

Kirsty Hunter ◽

Julie Johnston ◽

Massimiliano Zecca ◽

...

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Daily Living ◽

Wearable Technology ◽

Community Dwelling ◽

Use Of Technology ◽

Key Stakeholders ◽

Environmental Technologies ◽

Current Monitoring ◽

Future Work

The use of technology has been suggested as a means of allowing continued autonomous living for older adults, while reducing the burden on caregivers and aiding decision-making relating to healthcare. However, more clarity is needed relating to the Activities of Daily Living (ADL) recognised, and the types of technology included within current monitoring approaches. This review aims to identify these differences and highlight the current gaps in these systems. A scoping review was conducted in accordance with PRISMA-ScR, drawing on PubMed, Scopus, and Google Scholar. Articles and commercially available systems were selected if they focused on ADL recognition of older adults within their home environment. Thirty-nine ADL recognition systems were identified, nine of which were commercially available. One system incorporated environmental and wearable technology, two used only wearable technology, and 34 used only environmental technologies. Overall, 14 ADL were identified but there was variation in the specific ADL recognised by each system. Although the use of technology to monitor ADL of older adults is becoming more prevalent, there is a large variation in the ADL recognised, how ADL are defined, and the types of technology used within monitoring systems. Key stakeholders, such as older adults and healthcare workers, should be consulted in future work to ensure that future developments are functional and useable.

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