scholarly journals Frailty as a Moderator of the Relationship Between Social Isolation and Health Outcomes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 269-270
Author(s):  
Fereshteh Mehrabi ◽  
François Béland

Abstract Previous studies have reported that social isolation is a predictor of adverse outcomes, which is also closely associated with frailty. Very little is known about the moderating role of frailty on the impact of social isolation on health. We performed a cross-sectional analysis of the first wave of the FRéLE longitudinal study, consisting of 1643 Canadian community-dwelling older adults aged 65 years and over. Multivariate regression analysis was performed to examine the interaction between social isolation and frailty on health, controlling for socioeconomic characteristics and life habits. Social isolation was measured through social participation, social networks and support for different social ties namely, friends, children, extended family, and partner. In contrast to Berkman’s theory on the impact of social isolation on health, we found that frailty had no modifying role on the effects of social isolation on health. Frailty was significantly associated with all adverse outcomes. Less social participation was associated with ADLs, IADLs, depression and cognitive decline. The absence of friends was associated with depression and cognitive decline. Less support from children and having no children were associated with ADLs, comorbidity and depression. Fewer contact with extended family and having no family members were notably associated with ADLs and IADLs. Those who received less support from a partner or had no partner were more depressed and had more difficulties in performing IADLs. This study suggests that older adults who participate in social activities and have social ties, feel better with respect to physical health than those who feel isolated.

Author(s):  
Fereshteh Mehrabi ◽  
François Béland

This research investigated the effects of social isolation on frailty and health outcomes and tested whether these associations varied across different levels of frailty. We performed a multivariate analysis of data from the first wave of the FRéLE study among 1,643 Canadian older adults aged 65 years and over. We assessed social isolation using social participation, social networks, and support from various social ties, namely, friends, children, extended family, and partner. Frailty predicted disability, comorbidity, depression, and cognitive decline. Less social participation was associated with IADLs, depression, and cognitive decline. The absence of friends was associated with depression and cognitive impairment. Less social support from children and partner was related to comorbidity, depression, and cognitive decline. Overall, social isolation is linked to mental health, rather than physical health. The associations of having no siblings, receiving less support from friends, and participating less in social activities with ADL limitations, depression, and cognitive decline were higher among frail than pre-frail and robust older adults. This study corroborates the pivotal role of social connectedness, particularly the quality of relationships, on the mental health of older adults. Public health policies on social relationships are paramount to ameliorate the health status of frail older adults.


Author(s):  
Fereshteh Mehrabi ◽  
François Béland

This research investigated the effects of social isolation on frailty and health outcomes and tested whether these associations varied across different levels of frailty. We performed a multivariate analysis of the first wave of Frailty: A longitudinal study of its expressions (FRéLE) among 1643 Canadian older adults aged 65 years and over. We assessed social isolation using social participation, social networks, and support from various social ties, namely, friends, children, extended family, and partner. Frailty was associated with disability, comorbidity, depression, and cognitive decline. Less social participation was associated with limitations in instrumental activities of daily living (IADLs), depression, and cognitive decline. The absence of friends was associated with depression and cognitive impairment. Less social support from children and partner was related to comorbidity, depression, and cognitive decline. Overall, social isolation is linked to mental health rather than physical health. The associations of having no siblings, receiving less support from friends, and participating less in social activities with ADL limitations, depression, and cognitive decline were higher among frail than prefrail and robust older adults. This study corroborates the pivotal role of social connectedness, particularly the quality of relationships, on the mental health of older adults. Public health policies on social relationships are paramount to ameliorate the health status of frail older adults.


Author(s):  
Yuko Yamaguchi ◽  
Masako Yamada ◽  
Elsi Dwi Hapsari ◽  
Hiroya Matsuo

This study aimed to examine the relationship between one’s physical status related to non-communicable diseases (NCDs) and social isolation, and to identify lifestyle behaviors for the prevention of NCDs associated with social isolation among community-dwelling older adults in Japan. A cross-sectional study was conducted to investigate lifestyle behaviors for NCD prevention associated with social isolation in Japanese adults aged 60 years and above in a community setting. Out of 57 participants, 17.5% were not socially participative, 66.7% hardly ever, 29.8% sometimes, and 3.5% often felt loneliness. Non-social participation and loneliness were negatively related to the frequency of vegetable and fruit intake. Additionally, loneliness was positively associated with one’s duration of smoking and current smoking habits, and negatively associated with the frequency of moderate-intensity activities, with marginal significance. Those with non-social participation or loneliness were less likely to eat a healthy diet and live a smoke-free lifestyle. The findings of this study suggest that a mutual health support system in the community and the development of community-based approaches for the prevention of NCDs among Japanese older adults are needed.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 173-174
Author(s):  
Fereshteh Mehrabi ◽  
François Béland

Abstract Social isolation and frailty are global public health issues that may lead to poor health outcomes. We tested the two following hypotheses: 1) changes in social isolation and frailty are associated with adverse health outcomes over two years, 2) the associations between social isolation and health vary across different levels of frailty. We estimated a series of latent growth models to test our hypotheses using data from the FRéLE longitudinal study among 1643 Canadian community-dwelling older adults aged 65 years and over. Missing data were handled by pattern mixture models with the assumption of missing not at random. We measured social isolation through social participation, social networks, and social support from different social ties. We assessed frailty using Fried’s criteria. Our results revealed that higher frailty at baseline was associated with a higher rate of comorbidity, depression, and cognitive decline over two years. Less social participation at baseline was associated with comorbidity, depression, and changes in cognitive decline. Less social support from friends, children, partner, and family at baseline was associated with comorbidity, cognitive decline, and changes in depression. Fewer contacts with grandchildren were related to cognitive decline over time. The associations of receiving less support from partner with depression and participating less in social activities with comorbidity, depression, and cognitive decline were higher among frail or prefrail than robust older adults over time. This longitudinal study suggests that intimate connectedness and social participation may ameliorate health status in frail older populations, highlighting the importance of age-friendly city policies.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 240-240
Author(s):  
François Béland ◽  
Fereshteh Mehrabi

Abstract Social isolation is an emerging public health concern with an emphasis on its potential preventive impact on cognitive impairment. We hypothesize that change in social isolation is associated with cognitive decline over two years. Latent growth models were used to test the hypothesis using data from the FRéLE longitudinal study among 1643 Canadian community-dwelling older adults aged 65 years and over. We assessed social isolation using social participation, social networks, and support from various social ties. We found that less contact with friends and children, less social support from friends, children, and partner, and the absence of partner were significantly associated with cognitive decline. Higher baseline social participation was related to the lower rate of cognitive decline over time. Fewer contacts with grandchildren were associated with cognitive decline over time. Our study suggests that public health policies in age-friendly cities and intergenerational contacts may promote cognitive health in older adults.


2021 ◽  
Vol 10 (11) ◽  
pp. 2308
Author(s):  
Pascale Heins ◽  
Lizzy M. M. Boots ◽  
Wei Qi Koh ◽  
An Neven ◽  
Frans R. J. Verhey ◽  
...  

Social isolation in community-dwelling older adults with dementia is a growing health issue that can negatively affect health and well-being. To date, little attention has been paid to the role of technology in improving their social participation. This systematic review aims to provide a systematic overview of the effects of technological interventions that target social participation in community-dwelling older adults with and without dementia. The scientific databases Medline (PubMed), PsycINFO, CINAHL, Web of Science, and the Cochrane Library were systematically searched and independently screened by two reviewers. Results were synthesized narratively. The methodological quality of included studies was independently assessed by two reviewers. In total, 36 studies of varying methodological quality were identified. Most studies evaluated social networking technology and ICT training programs. Three studies focused on people with dementia. Quantitative findings showed limited effects on loneliness, social isolation, and social support. Nevertheless, several benefits related to social participation were reported qualitatively. Social interaction, face-to-face contact, and intergenerational engagement were suggested to be successful elements of technological interventions in improving the social participation of community-dwelling older adults. Rigorous studies with larger sample sizes are highly needed to evaluate the long-term effects of technology on the multidimensional concept of social participation.


Author(s):  
Takafumi Abe ◽  
Kenta Okuyama ◽  
Tsuyoshi Hamano ◽  
Miwako Takeda ◽  
Masayuki Yamasaki ◽  
...  

Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01–1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.


2021 ◽  
pp. 026921552110505
Author(s):  
Qi Lu ◽  
Dongrui Wang ◽  
Li Fu ◽  
Xue Wang ◽  
LiYa Li ◽  
...  

Objective To explore the effect of stigma on social participation in community-dwelling Chinese patients with stroke sequelae. Design A cross-sectional survey study. Setting The study was conducted in two community centres in Tianjin, China. Subjects Community-dwelling Chinese patients with stroke sequelae. Measures Chinese version of Stigma Scale for Chronic Illness, Chinese version of Impact on Participation and Autonomy, Modified Barthel index, Self-Rating Depression Scale, Social Support Rating Scale, Medical Coping Modes Questionnaire, background and disease-related questions. Pearson’s correlation coefficients were computed between stigma and social participation. The impact of stigma on social participation was estimated by hierarchical multiple regression analysis after controlling for demographic, physical and psychosocial characteristics. Results In total, 136 patients with stroke sequelae were included in this study, with a mean age of 67.8 years. The Chinese version of the Stigma Scale for Chronic Illness had a mean score of 48.4 (SD 16.9), and the Chinese version of the Impact on Participation and Autonomy was 67.1 (SD 21.1). Significant correlations were found between stigma and social participation. Pearson’s correlation coefficient ranged from 0.354 to 0.605 ( P < 0.01). Enacted stigma provided a significant explanation for the variance of social participation by 1.1% ( P < 0.05). Felt stigma provided a significant explanation for the variance of social participation by 2.9% ( P < 0.001). Conclusion Felt stigma and enacted stigma have independent associations with social participation. Patients with stroke sequelae who reported higher stigma experienced a lower level of social participation.


2021 ◽  
Vol 15 ◽  
Author(s):  
Anne Sophie Grenier ◽  
Louise Lafontaine ◽  
Andréanne Sharp

It is well known and documented that sensory perception decreases with age. In the elderly population, hearing loss and reduced vestibular function are among the most prevalently affected senses. Two important side effects of sensory deprivation are cognitive decline and decrease in social participation. Hearing loss, vestibular function impairment, and cognitive decline all lead to a decrease in social participation. Altogether, these problems have a great impact on the quality of life of the elderly. This is why a rehabilitation program covering all of these aspects would therefore be useful for clinicians. It is well known that long-term music training can lead to cortical plasticity. Behavioral improvements have been measured for cognitive abilities and sensory modalities (auditory, motor, tactile, and visual) in healthy young adults. Based on these findings, it is possible to wonder if this kind of multisensory training would be an interesting therapy to not only improve communication but also help with posture and balance, cognitive abilities, and social participation. The aim of this review is to assess and validate the impact of music therapy in the context of hearing rehabilitation in older adults. Musical therapy seems to have a positive impact on auditory perception, posture and balance, social integration, and cognition. While the benefits seem obvious, the evidence in the literature is scarce. However, there is no reason not to recommend the use of music therapy as an adjunct to audiological rehabilitation in the elderly when possible. Further investigations are needed to conclude on the extent of the benefits that music therapy could bring to older adults. More data are needed to confirm which hearing abilities can be improved based on the many characteristics of hearing loss. There is also a need to provide a clear protocol for clinicians on how this therapy should be administered to offer the greatest possible benefits.


2020 ◽  
Author(s):  
Jessica Marian Goodman-Casanova ◽  
Elena Dura-Perez ◽  
Gloria Guerrero-Pertiñez ◽  
Pilar Barnestein-Fonseca ◽  
Jose Guzman-Parra ◽  
...  

BACKGROUND Coronavirus disease 2019 has forced worldwide the implementation of unprecedented restrictions to control its rapid spread and mitigate its impact. The Spanish government has enforced social distancing, quarantine and home confinement. This restriction of daily life activities and separation from loved ones may lead to social isolation and loneliness with health-related consequences in community-dwelling older adults with mild cognitive impairment or mild dementia and their caregivers. Additionally, an inadequate access to healthcare and social support services may aggravate chronic conditions. Technology home-based interventions emerge for combating social isolation and loneliness preventing the risk of viral exposure. OBJECTIVE The aim of this cohort study is to explore, analyze and determine the impact of social isolation on: 1) cognition, quality of life, mood, technophilia and perceived stress of community-dwelling older adults with mild cognitive impairment or mild dementia, and on caregiver burden; 2) health and social care services access and utilization, and 3) cognitive, social and entertainment use of ICTs. METHODS This study will be conducted in the Spanish region of Andalucía (Málaga). In total 200 dyads, consisting of a person with mild cognitive impairment or mild dementia (PMCI/MD) and their informal caregiver will be contacted by telephone. Potential respondents will be participants of the SMART 4 MD (N=100) and TV-AssistDem (N=100) clinical trials. RESULTS The change in means in the variables will be analyzed comparing baseline results in the previous studies with those during and after confinement using the ANOVA test of repeated measures or the non-parametric Friedman test if appropriate. The performance of a multivariate analysis of variance (ANCOVA) to introduce possible covariates will also be contemplated. A 95% confidence level will be used. CONCLUSIONS If the hypothesis is proven, these findings will demonstrate the negative impact of social isolation due to the COVID-19 confinement on cognition, quality of life, mood, and perceived stress of community-dwelling older adults with mild cognitive impairment and mild dementia, the impact on technophilia, caregiver burden, and health and social care services access and utilization; and the cognitive, social and entertainment use of ICTs during the COVID-19 confinement and afterwards. CLINICALTRIAL NCT: 04385797


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