Loneliness and Social Connectedness Among Rural Older Adults Since the COVID-19 Pandemic Onset

Abstract Rural areas have a higher proportion of older adults aging in place. Rural areas also face structural barriers to supporting social connectedness among older adults, including transportation barriers, greater geographic distances, and access to technological connectivity. This research aims to discuss rural-specific risks of loneliness and social isolation among older adults, as well as rural/urban differences in loneliness and social isolation among older adults using the national COVID-19 Coping Study. Cross-sectional bivariate analyses highlight rural/urban differences in social activities during the pandemic. For example, rural older adults were more likely to use social media daily, compared with urban older adults (67% vs. 61%, p<0.05), but were less likely to have phone or video calls with others daily (21% vs. 26%, p<0.001). We will also share results of differences within rural older adults in loneliness, isolation, and social activities by socio-demographic characteristics in order to design targeted interventions to improve connectedness.

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Urban-rural differences in the association between social activities and depressive symptoms among older adults in China: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-021-02541-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yanan Wang ◽

Zhen Li ◽

Chang Fu

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Multivariate Logistic Regression Analysis ◽

Depression Scale ◽

Social Activities ◽

Positive Health ◽

Cross Sectional ◽

Chinese Older Adults ◽

Urban Rural ◽

Rural Older Adults

Abstract Background Participation in social activities has positive health effects among older adults; however, few studies have investigated the association between social activity and depressive symptoms among Chinese older adults. This study aimed to examine the association between social activities and depressive symptoms among older adults in China regarding urban-rural differences. Methods Data were collected from 8255 respondents from the 2015 China Health and Retirement Longitudinal Study. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Type and frequency of social activities were collected via a questionnaire. Multivariate logistic regression analysis was used to explore the relationship between social activities and depressive symptoms. Results In our study, the prevalence of depressive symptoms was lower in urban older adults compared with rural older adults (25.2% vs. 40.7%). After adjustment for all covariates, our results indicated that interacting with friends almost weekly or almost daily (almost weekly: OR = 0.568, 95%CI: 0.337–0.955; almost daily: OR = 0.664, 95%CI: 0.453–0.973) and participating in community organizations almost daily were inversely associated with depressive symptoms among urban older adults (OR = 0.107, 95%CI: 0.012–0.952). Interacting with friends almost daily (OR = 0.847, 95% CI: 0.720–0.996) and participation in hobby groups either almost every week or almost daily were both inversely associated with depressive symptoms among rural older adults (almost weekly: OR = 0.683, 95%CI: 0.518–0.902; almost daily: OR = 0.567, 95%CI: 0.440–0.731). Participating in sports groups almost daily was inversely associated with depressive symptoms among both urban and rural older adults (urban: OR = 0.664, 95%CI: 0.445–0.991; rural: OR = 0.506, 95%CI: 0.366–0.700). Conclusions Our findings indicated that there is a cross-sectional association between participation in social activities and depressive symptoms among Chinese older adults, and the association differed between urban and rural older adults. This implies that participation in social activities may be significant for alleviating depressive symptoms of older adults. When encouraging older adults to participate in social activities, the government should consider urban-rural differences and take effective measures accordingly. Longitudinal studies are needed to examine the causal relationships between social activities and depressive symptoms among older adults.

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Aging in Place: Social Connectedness and the Health of Older Subsidized Housing Residents

Innovation in Aging ◽

10.1093/geroni/igab046.520 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 135-135

Author(s):

Thomas Cudjoe ◽

Judith Gonyea ◽

Robyn Stone

Keyword(s):

Risk Factors ◽

Older Adults ◽

Health Outcomes ◽

Social Isolation ◽

Social Connectedness ◽

Aging In Place ◽

Subsidized Housing ◽

Life Course Perspective ◽

High Risk Population ◽

Social Connection

Abstract Findings on the prevalence and impacts of loneliness and social isolation on the lives of older adults have led to the lack of social connectedness being viewed as a major public health issue. Although an understudied population, emerging evidence suggests that for the nearly 3 million older low-income adults living in subsidized housing the impacts of lack of social connection may be especially profound. From a life course perspective, “cumulative economic disadvantage,” if combined with a “cumulative connectedness disadvantage,” may heighten exposure to health risk factors and negative health outcomes. Addressing social risk factors in this population thus may have the potential to reduce health disparities as well as improve quality of life. Decades of epidemiologic evidence suggest that social isolation is a key factor in disparate outcomes. Evidence-based interventions are needed to improve aging in place for this population, but little is known about the individual or contextual factors that influence social connectedness and health among this high-risk population of older adults. This symposium includes interdisciplinary perspectives and methods as well as present results from four studies that examine 1) perspectives on aging in place in subsidized housing, 2) relationship between social connection and food insecurity 3) relationship between social isolation and healthcare utilization and 4) between resident ties and links to health outcomes. Papers in this symposium will highlight the implications of study findings for informing future interventions to improve aging in place for older adults living in subsidized housing.

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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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Rural–Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062818 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2818

Author(s):

Yuri Sasaki ◽

Yugo Shobugawa ◽

Ikuma Nozaki ◽

Daisuke Takagi ◽

Yuiko Nagamine ◽

...

Keyword(s):

Older Adults ◽

Middle School ◽

Depressive Symptoms ◽

Rural Areas ◽

Urban Areas ◽

Depression Scale ◽

Wealth Index ◽

School Level ◽

Cross Sectional ◽

Middle School Level

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

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Digital Technologies To Enhance Social Connectedness in Long-Term Care Facilities During COVID-19: A Review

Innovation in Aging ◽

10.1093/geroni/igaa057.3451 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 942-943

Author(s):

Shannon Freeman ◽

Aderonke Abgoji ◽

Alanna Koopmans ◽

Christopher Ross

Keyword(s):

Social Isolation ◽

Rural Areas ◽

Social Connectedness ◽

Long Term Care ◽

Care Facility ◽

Well Being ◽

Sufficient Information ◽

Term Care ◽

Care Facilities

Abstract A consequence of the strict visitor restrictions implemented by many Long-term Care Facilities (LTCFs), during the COVID-19 pandemic, was the exacerbation of loneliness and social isolation felt by older adult residents. While there had been a shift by some persons to utilize digital solutions to mitigate the effects of the imposed social isolation, many facilities did not have sufficient information regarding available solutions to implement institutional strategies to support social connectedness through digital solutions. To support our partners in evidence-based policy-making we conducted a scoping review to identify existing virtual technology solutions, apps, and platforms feasible to promote social connectedness among persons residing in a long-term care facility context during times of lockdown such as experienced during the COVID-19 pandemic. Initial identification of relevant literature involved a combination of keywords and subject headings searches within 5 databases (PubMed, CINAHL EBSCO, PsychINFO EBSCO, Embase OVIDSP, and Web of Science ISI). DistillerSR was used to screen, chart and summarize the data. There is growth in the availability of technologies focused on promoting health and well-being in later life for persons in long-term care facilities however a gap remains in widespread uptake. We will describe the breadth of technologies identified in this review and discuss how they vary in utility in smaller scale facilities common in rural areas. Of the technologies that can be used to mitigate the impacts of social isolation felt by long-term care residents, many “solutions” depend on stable highspeed internet, which remains a challenge in rural and northern areas.

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Associations Between Hearing Loss, Loneliness, and Social Isolation: A Systematic Review

Innovation in Aging ◽

10.1093/geroni/igaa057.1018 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 318-318

Author(s):

Jonathan Suen ◽

Aishwarya Shukla ◽

Adele Goman ◽

Carrie Price ◽

Frank Lin ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Social Isolation ◽

Psychosocial Health ◽

Cochrane Library ◽

Cross Sectional ◽

Design Assessment ◽

Aural Rehabilitation ◽

Rehabilitation Programs ◽

Underlying Mechanisms

Abstract Hearing loss is highly prevalent among older adults, as is occurrences of loneliness and social isolation. Both loneliness and social isolation are also associated with insidious outcomes such as earlier mortality from all-causes and higher prevalence of chronic comorbidities. The purpose of this review is to synthesize published investigations that report on the associations between hearing loss with loneliness and social isolation. A systematic search through PubMed, Embase, CINAHL Plus, PsycINFO, and the Cochrane Library identified an initial total of 2495 references. Two independent reviewers screened articles for inclusion, with a third reviewer adjudicating. Studies published in English of older adults with hearing loss that also assessed loneliness and/or social isolation using a validated measure were included. Investigators used a modified Newcastle-Ottawa Scale (NOS) to appraise study quality. A final total of 14 articles were included in the review. The majority (12/14) were cross-sectional in design. Assessment methods were varied across hearing status, loneliness, and social isolation. Despite this heterogeneity, most multivariable adjusted investigations revealed that hearing loss was significantly associated with higher risks for both phenomena. Several studies also revealed this association to vary across gender, with women showing a stronger association than men. Our findings indicate that hearing loss is associated with both loneliness and social isolation, which have important implications for the cognitive and psychosocial health of older adults. Future investigations should examine possible underlying mechanisms of these relationships, as well as the efficacy of interventions through aural rehabilitation programs in addressing loneliness and social isolation.

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Changes in Tobacco Use Patterns during COVID-19 and Their Correlates among Older Adults in Bangladesh

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041779 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1779

Author(s):

Sabuj Kanti Mistry ◽

Armm Mehrab Ali ◽

Md. Ashfikur Rahman ◽

Uday Narayan Yadav ◽

Bhawna Gupta ◽

...

Keyword(s):

Older Adults ◽

Tobacco Use ◽

Rural Areas ◽

Cross Sectional Study ◽

Cross Sectional ◽

Policy Makers ◽

Use Patterns ◽

Telephone Interviews ◽

Related Information ◽

Structured Questionnaire

The present study explored the changes in tobacco use patterns during the COVID-19 pandemic and their correlates among older adults in Bangladesh. This cross-sectional study was conducted among 1032 older adults aged ≥60 years in Bangladesh through telephone interviews in October 2020. Participants’ characteristics and COVID-19-related information were gathered using a pretested semi-structured questionnaire. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic (6 months prior to the survey). Nearly half of the participants (45.6%) were current tobacco users, of whom 15.9% reported increased tobacco use during the COVID-19 pandemic and all others had no change in their tobacco use patterns. Tobacco use was significantly increased among the participants from rural areas, who had reduced communications during COVID-19 compared to pre-pandemic (OR = 2.76, 95%CI:1.51–5.03). Participants who were aged ≥70 years (OR = 0.33, 95% CI: 0.14–0.77), widowed (OR = 0.36, 95% CI: 0.13–1.00), had pre-existing, non-communicable, and/or chronic conditions (OR = 0.44, 95% CI: 0.25–0.78), and felt themselves at the highest risk of COVID-19 (OR = 0.31, 95% CI: 0.15–0.62), had significantly lower odds of increased tobacco use. Policy makers and practitioners need to focus on strengthening awareness and raising initiatives to avoid tobacco use during such a crisis period.

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Effects of Participation in Social Activities on Cognitive Function Among Middle-Aged and Older Adults in Korea

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15102315 ◽

2018 ◽

Vol 15 (10) ◽

pp. 2315 ◽

Cited By ~ 3

Author(s):

Jongnam Hwang ◽

Sangmin Park ◽

Sujin Kim

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Social Connectedness ◽

Social Activity ◽

Later Life ◽

Well Being ◽

Social Activities ◽

The Social ◽

Gender Groups

Cognitive function is a critical health issue in later life, the decline of which disrupts well-being and daily life function. Cognitive decline in older ages can also be understood in the context of the social environment such as social connectedness and engagement in personal life. This study aimed to examine: (1) whether participation in social activities contributes to preventing cognitive decline, and (2) what type of social activities are beneficial to maintaining cognitive function. Data from the Korean Longitudinal Study of Aging (KLOSA) 2006–2014, a longitudinal survey of the household-dwelling population aged 45 and older in Korea were used. The results revealed that Mini-Mental State Examination (MMSE) scores decreased with increasing age, at a rate of approximately 0.18 units across all age-gender groups, and the decrease was steeper for adults aged 65 and over. Participation in social gatherings was likely to delay the decline in cognitive function after the age of 65. In a gender-stratified model, social activity may not have an impact on the decline of cognitive function for men, whereas participation in social gatherings was negatively related to the decline of MMSE scores in women. This study suggests the need for a gender-stratified policy for preventing the decline of cognitive function while promoting engagement in social activities in Korean older adults.

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Urban-rural differences in the prevalence of muscle weakness and slow gait speed: A cross-sectional analysis from the NHANES (2001-2002 and 2011-2014)

Journal of Aging Research and Lifestyle ◽

10.14283/jarlife.2021.4 ◽

2021 ◽

pp. 1-7

Author(s):

J.J. Aziz ◽

K.F. Reid ◽

J.A. Batsis ◽

R.A. Fielding

Keyword(s):

United States ◽

Older Adults ◽

Grip Strength ◽

Muscle Weakness ◽

Rural Areas ◽

Gait Speed ◽

The United States ◽

Cross Sectional ◽

Comorbidity Burden ◽

Urban Rural

Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.

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Older adults experiences of technology use for socialization during the COVID-19 pandemic: A random cross-sectional survey (Preprint)

10.2196/preprints.28010 ◽

2021 ◽

Author(s):

Kristen R. Haase ◽

Theodore Cosco ◽

Lucy Kervin ◽

Indira Riadi ◽

Megan E. O'Connell

Keyword(s):

Mental Health ◽

Older Adults ◽

British Columbia ◽

Social Isolation ◽

Technology Use ◽

Random Sampling ◽

Population Based ◽

Critical Approach ◽

Cross Sectional Survey ◽

Cross Sectional

BACKGROUND Technology has become the most critical approach to maintain social connectedness during the COVID-19 pandemic. Older adults (over age 65) are perceived as most physiologically vulnerable to COVID-19 and at risk of secondary mental health challenges related to social isolation imposed by virus containment strategies. To mitigate concerns regarding sampling bias we used a random sampling of older adults to understand uptake and acceptance of technologies to support socialization during the pandemic. OBJECTIVE To conduct a random population-based assessment of the barriers and facilitators to engaging in technology use for virtual socialization amongst older adults in the Canadian province of British Columbia during the COVID-19 pandemic. METHODS We conducted a cross-sectional population-based survey using random-digit dialing to participants over age 65 living in British Columbia. Data were analyzed using SPSS, with open-text responses analyzed using thematic analysis. RESULTS Respondents included 400 older adults with an average age of 72 years old and 63.7% female. Most respondents (89.5%) were aware of how to use technology to connect with others and slightly more than half (56%) reported using technology differently to connect with others during the pandemic. 55.9% of respondents reported adopting new technology since the beginning of the pandemic. Older adults reported key barriers to using technology including: (1) lack of access (including finance, knowledge, and age); (2) lack of interest (including a preference for telephone, and a general lack of interest in computers); and (3) physical barriers (resultant of cognitive impairments, stroke, and arthritis). Older adults reported numerous facilitators, including: (1) knowledge of technologies (whether self-taught or via external courses); (2) reliance on others (family, friends, and general internet searching); (3) technology accessibility (including environments, user-friendly technology, and receiving clear instructions); and (4) social motivation (because everyone else is doing it). CONCLUSIONS Much data on older adults use of technology is limited by sampling biases, but the current study that used random sampling demonstrated that older adults used technology to mitigate social isolation during the pandemic. Virtual socialization is most promising to mitigate potential mental health effects related to virus containment strategies. Addressing barriers by mobilizing telephone training and task lists, and mobilizing facilitators described by participants such as facilitated socialization activities are important strategies that can be implemented within and beyond the pandemic to bolster the mental health needs of older adults.

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