HOW ARE SOCIAL ISOLATION AND LONELINESS RELATED TO COGNITIVE FUNCTIONING AMONG CHINESE OLDER ADULTS?

Abstract Older adults have increased risk of social isolation, loneliness, and cognitive functioning decline, but the relationships among these factors are not conclusive. We used the 2011 and 2012 waves of the harmonized China Health and Retirement Longitudinal Study to: 1) measure the association between social isolation and cognitive functioning among Chinese older adults within their cultural context, and 2) investigate the potential mediation mechanism of loneliness on this association. Specifically, we applied a multiple indicator multiple cause approach to determine whether the construct of social isolation is well defined by four indicators (social activity engagement, weekly adult children contact, caregiving for grandchildren, and living alone). We used structural equation modeling to examine the direct and indirect effects among variables of interest. The results demonstrated that three indicators of social isolation were significantly associated with cognitive functioning (β =-0.26 to -0.28, all ps<0.05). The indirect effect of social isolation on cognitive functioning through loneliness was significant (β = -0.15, p<0.05), indicating loneliness was an important mediator. After controlling for the indirect effect of loneliness, the direct effect of social isolation on cognitive functioning remained significant (β =-0.83, p<0.05), suggesting a partial mediation effect. Our study confirms that social isolation contributes to cognitive functioning decline among Chinese older adults and that loneliness plays a mediating role. The findings suggest maintaining social relations and coping with feelings of loneliness are beneficial to older adults’ cognitive functioning.

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Effects of perceived social isolation, fear of social isolation and gratitude during COVID-19 pandemic on anxiety in Malaysia (Preprint)

10.2196/preprints.29808 ◽

2021 ◽

Author(s):

Cher Yi Tan ◽

Jia Yi Ng ◽

Mei-Hua Lin ◽

Min Hooi Yong

Keyword(s):

Older Adults ◽

Young Adults ◽

Social Isolation ◽

Indirect Effect ◽

Moderating Effect ◽

Mediating Effect ◽

Mediation Effect ◽

Mediation Model ◽

Middle Aged ◽

Perceived Social Isolation

BACKGROUND The COVID-19 pandemic compelled many countries including Malaysia to impose movement restrictions to curb spreading the virus. Evidence shows that prolonged isolation has negative effects on both physical and mental health. OBJECTIVE Our aims were to examine (1) the mediating effect of perceived social isolation (SI) and fear of social isolation (FSI) on the relationship between gratitude and anxiety, and (2) to explore the moderating effect of age, education and socioeconomic status on the mediation model. METHODS We collected data from 427 participants currently living in Malaysia during the movement restriction order (Mage = 37.90, SD = 16.51, 313 females) from an online survey containing questions pertaining to isolation and gratitude. RESULTS Our mediation analysis showed that gratitude has a positive effect on overcoming anxiety as it also lowers feelings of SI and FSI (B = -.229, β = .128, bootstrap SE = .049, 95% bootstrap CI = [-.332, -.138]). The moderated mediation analyses revealed the indirect effect of gratitude on anxiety through SI was significant for young adults (B = -.148, β = .083, 95% bootstrap CI [-.274, -.042]) and middle-aged (B = -.099, β = -.055, 95% bootstrap CI [-.177, -.033]) but not for older adults (B = -.026, β = -.015, 95% bootstrap CI [-.129, .047]). Results were similar for FSI in that it was significant for middle aged and not significant for older adults (all CIs does not include zero). However the mediation effect was not significant for young adults (B = -.020, β = -.011, 95% bootstrap CI [-.066, .016]). When we examined the moderating effect of education and SES in the parallel mediation model, results showed that the mediation effect of SI and FSI for those with lower levels of education was significant for all SES levels (all CIs did not contain zero). As for those with medium levels of education, the conditional indirect effect of SI and FSI was significant only for low and medium levels of SES but not for high SES. CONCLUSIONS Our findings highlight the importance of having some coping mechanism and social connection during the pandemic to have higher wellbeing and quality of life, especially for middle-aged sample and people from low education and SES background. CLINICALTRIAL None

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Loneliness as a mediator of the impact of social isolation on cognitive functioning of Chinese older adults

Age and Ageing ◽

10.1093/ageing/afaa020 ◽

2020 ◽

Vol 49 (4) ◽

pp. 599-604 ◽

Cited By ~ 4

Author(s):

Rumei Yang ◽

Haocen Wang ◽

Linda S Edelman ◽

Eunjin L Tracy ◽

George Demiris ◽

...

Keyword(s):

Older Adults ◽

Cognitive Functioning ◽

Social Isolation ◽

Adult Children ◽

Social Activity ◽

Community Dwelling ◽

Living Alone ◽

Activity Engagement ◽

Chinese Older Adults ◽

The Impact

Abstract Background and Objective older adults have increased risk of social isolation, loneliness and cognitive functioning impairment, but the relationships among these factors are not conclusive. We investigated the potential mediation mechanism of loneliness on the association between social isolation and cognitive functioning among Chinese older adults within their cultural context. Design secondary analysis of the baseline wave (2011–12) of the harmonised China Health and Retirement Longitudinal Study. Setting and Subjects community-dwelling older adults in China (N = 7,410 participants aged 60–101 years). Methods we applied a multiple indicator multiple cause approach to determine whether the construct of social isolation is well defined by four indicators (social activity engagement, weekly adult children contact, caregiving for grandchildren and living alone) and used structural equation modelling to examine the direct and indirect effects among variables of interest. Results the results demonstrated that social activity engagement, weekly adult children contact and caregiving for grandchildren were significantly related to social isolation (β = −0.26 to −0.28) (Living alone was fixed to 1 for model identification.) The indirect effect of social isolation on cognitive functioning through loneliness was significant (β = −0.15), indicating loneliness was an important mediator. However, the direct effect of social isolation on cognitive functioning also remained significant (β = −0.83), suggesting a partial mediation effect. Conclusions our study highlights the mediation role of loneliness in the relationship between social isolation and cognitive functioning among Chinese older adults. The findings support the beneficial effects of maintaining social relations and coping with feelings of loneliness on older adults’ cognitive functioning.

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BACK TO BASICS: HOPELESSNESS AS THE MEDIATING FACTOR FOR COMPLETED SUICIDE AMONG OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.1001 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S269-S270

Author(s):

Silvia C Hernandez ◽

James C Overholser ◽

James Lavacot ◽

Kristie L Philips ◽

Craig A Stockmeier

Keyword(s):

Risk Factors ◽

Older Adults ◽

Social Isolation ◽

Structural Equation ◽

Physical Illness ◽

Advanced Age ◽

Equation Modeling ◽

Psychological Autopsy ◽

Increased Risk ◽

Increase Risk

Abstract Individuals 65 years and older are at high risk for completing suicide. Though risk factors have been established in the literature, the dominant atheoretical approach has left the field at an impasse. The present study aimed to integrate core risk factors of hopelessness, depression, physical illness, and social isolation by proposing a biopsychosocial framework of older adult suicide. A psychological autopsy was used to compare individuals 65 years and older who died either by suicide (n = 32) or natural causes (n = 45). Structural equation modeling results suggested that hopelessness was the only factor directly associated with suicide (B = .01, β = 0.84, SE = 13.31, p ≤ .001), fully mediating the relationships between suicide and social isolation, negative attitudes about physical health, and depression. The proposed model adequately fit the data, explaining 71% of the variance in cause of death. Advanced age (75+ years) moderately increased social isolation, which weakly increased hopelessness, contributing to suicide in a smaller magnitude than expected. Though individuals in the advanced age group had a wider range of physical illnesses, this did not increase risk. Rather, negative perceptions of health increased risk for all individuals 65 years and older via depression and hopelessness, irrespective of the presence of impairing physical illness. Findings support the claim that hopelessness plays a pivotal role in the progression from suicidal ideation to completion among older adults. Directly targeting hopelessness could help prevent at-risk older adults from acting on their thoughts of suicide.

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Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

Psychological Medicine ◽

10.1017/s0033291720001026 ◽

2021 ◽

pp. 1-8

Author(s):

Bin Yu ◽

Andrew Steptoe ◽

Yongjie Chen ◽

Xiaohua Jia

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Cognitive Function ◽

Episodic Memory ◽

Cognitive Decline ◽

Social Isolation ◽

Mental Status ◽

Chinese Older Adults ◽

Confounding Variables

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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Understanding How Cumulative Victimization Predicts Future Victimization Risk: Relevance of Cognitive Versus Social Mediation

Criminal Justice Review ◽

10.1177/07340168211015725 ◽

2021 ◽

pp. 073401682110157

Author(s):

Thomas Wojciechowski

Keyword(s):

Indirect Effect ◽

Sensation Seeking ◽

Service Providers ◽

Social Factor ◽

Equation Modeling ◽

Mediation Effects ◽

Systems Model ◽

Victimization Risk ◽

Increased Risk ◽

Peer Association

Cumulative victimization represents the summation of victimization experiences across multiple contexts, with greater accumulation generally predicting greater dysfunction than less accumulation of exposures. Past research has indicated that cumulative victimization predicts increased risk for future revictimization also. The dual systems model may help to understand this relationship. This framework comprises constructs of sensation-seeking and impulse control in developmental context. Deviant peer association may provide a social factor that helps to understand this relationship. Victimization has been found to influence all of these constructs identified here. It is predicted that increased accumulation of victimization experiences may drive variation in these constructs that results in elevated risk for revictimization. This study sought to test the theory that each of these three constructs independently mediated the cumulative victimization–revictimization relationship. The Pathways to Desistance data were used in analyses. This sample was comprised of 1,354 juvenile offenders followed for 7 years after a recent adjudication prior to baseline measurements. The first three waves of data were used in analyses. Generalized structural equation modeling was used to test for the relationships of interest. A bootstrapping process of computing standard errors was carried out to determine significance of mediation effects. Results indicated that increased cumulative victimization scores at baseline predicted increased probability of experiencing victimization at Wave 3. This relationship was attenuated by about 15% when all mediators were added to the model and the relationship remained significant. Further analyses indicated that the specific indirect effect running through deviant peer association was significant, as was the total indirect effect. Findings indicate that increases in cumulative victimization may result in increased affiliation with deviant peers that further increases their future victimization risk. Service providers for survivors of violence should focus on screening of social relationships of those they provide care for in order to assess safety concerns.

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Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137067 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7067

Author(s):

Esther García-Esquinas ◽

Rosario Ortolá ◽

Iago Gine-Vázquez ◽

José A. Carnicero ◽

Asier Mañas ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Older Adults ◽

Social Isolation ◽

Community Dwelling ◽

Housing Conditions ◽

Older Individuals ◽

Lifestyle Risk Factors ◽

Increased Risk ◽

Lifestyle Risk

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

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Social Isolation in Chinese Older Adults: Scoping Review for Age-Friendly Community Planning

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980817000101 ◽

2017 ◽

Vol 36 (2) ◽

pp. 223-245 ◽

Cited By ~ 10

Author(s):

M. Anum Syed ◽

Lynn McDonald ◽

Corinne Smirle ◽

Karen Lau ◽

Raza M. Mirza ◽

...

Keyword(s):

Older Adults ◽

Social Isolation ◽

Scoping Review ◽

Community Planning ◽

Services De Santé ◽

Chinese Older Adults ◽

Milieu Urbain ◽

Participation Sociale

RÉSUMÉLes adultes chinois plus âgés peuvent être exposés à un risque accru d’isolement social et de solitude; pourtant, une telle compréhension des défis auxquels ils peuvent faire face pour la participation sociale dans leurs quartiers et communautés est fragmentée. Un examen de la portée a été entrepris pour décrire les connaissances actuelles sur l’isolement social et la solitude chez les aînés chinois vivant en milieu urbain dans les sociétés occidentales afin d’éclairer les recherches, les pratiques et les politiques futures au Canada. Dix-neuf articles répondent aux critères d’inclusion. Le système des communautés conçues pour les adultes vieillisantes de l’Organisation mondiale de la Santé a contextualisé les résultats de l’étude. Les études ont identifié des questions liées (1) à la participation sociale; (2) au soutien communautaire et aux services de santé; (3) au logement; (4) à la communauté et à l’information; (5) au respect et à l’inclusion sociale; (6) aux espaces extérieurs et aux édifices publics; (7) à la participation civique et à l’emploi; et (8) au transport. L’isolement social et la solitude sont des préoccupations croissantes au sein de cette population au Canada, et des recherches supplémentaires sont nécessaires pour en déterminer la portée et les interventions efficaces.

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Reducing Isolation and Loneliness Through Membership in a Fitness Program for Older Adults: Implications for Health

Journal of Applied Gerontology ◽

10.1177/0733464818807820 ◽

2018 ◽

Vol 39 (3) ◽

pp. 301-310 ◽

Cited By ~ 10

Author(s):

Samantha Brady ◽

Lisa A. D’Ambrosio ◽

Adam Felts ◽

Elizabeth Y. Rula ◽

Kenneth P. Kell ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Social Isolation ◽

Indirect Effect ◽

Future Research ◽

Direct Effects ◽

Fitness Program ◽

Self Rated Health ◽

Independent Effects ◽

Survey Responses

Objectives: To explore the effects of membership in a fitness program for older adults on social isolation, loneliness, and health. Method: Using survey responses from SilverSneakers members and matched nonmembers, regression path analysis was used to examine the influence of SilverSneakers membership on physical activity, social isolation, loneliness, and health, and the interrelationships among these concepts. Results: SilverSneakers membership directly increased physical activity and self-rated health, directly decreased social isolation, and indirectly decreased loneliness. Decreased social isolation and loneliness were associated with better self-rated health: social isolation and loneliness had independent direct effects on health, while social isolation also had an indirect effect on health mediated through loneliness. Discussion: Members of SilverSneakers experienced better health through increased physical activity, reduced social isolation, and reduced loneliness. Future research should explore independent effects of social isolation and loneliness on health and the mechanisms by which membership reduces social isolation and loneliness.

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Benefits of Higher Cardiovascular and Motor Coordinative Fitness on Driving Behavior Are Mediated by Cognitive Functioning: A Path Analysis

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.686499 ◽

2021 ◽

Vol 13 ◽

Author(s):

Robert Stojan ◽

Navin Kaushal ◽

Otmar Leo Bock ◽

Nicole Hudl ◽

Claudia Voelcker-Rehage

Keyword(s):

Older Adults ◽

Physical Fitness ◽

Cognitive Functioning ◽

Indirect Effect ◽

Dual Task ◽

Processing Speed ◽

Cognitive Functions ◽

Driving Performance ◽

Cardiovascular Fitness ◽

Lane Keeping

Driving is an important skill for older adults to maintain an independent lifestyle, and to preserve the quality of life. However, the ability to drive safely in older adults can be compromised by age-related cognitive decline. Performing an additional task during driving (e.g., adjusting the radio) increases cognitive demands and thus might additionally impair driving performance. Cognitive functioning has been shown to be positively related to physical activity/fitness such as cardiovascular and motor coordinative fitness. As such, a higher fitness level might be associated with higher cognitive resources and may therefore benefit driving performance under dual-task conditions. For the first time, the present study investigated whether this association of physical fitness and cognitive functioning causes an indirect relationship between physical fitness and dual-task driving performance through cognitive functions. Data from 120 healthy older adults (age: 69.56 ± 3.62, 53 female) were analyzed. Participants completed tests on cardiovascular fitness (cardiorespiratory capacity), motor coordinative fitness (composite score: static balance, psychomotor speed, bimanual dexterity), and cognitive functions (updating, inhibition, shifting, cognitive processing speed). Further, they performed a virtual car driving scenario where they additionally engaged in cognitively demanding tasks that were modeled after typical real-life activities during driving (typing or reasoning). Structural equation modeling (path analysis) was used to investigate whether cardiovascular and motor coordinative fitness were indirectly associated with lane keeping (i.e., variability in lateral position) and speed control (i.e., average velocity) while dual-task driving via cognitive functions. Both cardiovascular and motor coordinative fitness demonstrated the hypothesized indirect effects on dual-task driving. Motor coordinative fitness showed a significant indirect effect on lane keeping, while cardiovascular fitness demonstrated a trend-level indirect effect on speed control. Moreover, both fitness domains were positively related to different cognitive functions (processing speed and/or updating), and cognitive functions (updating or inhibition), in turn, were related to dual-task driving. These findings indicate that cognitive benefits associated with higher fitness may facilitate driving performance. Given that driving with lower cognitive capacity can result in serious consequences, this study emphasizes the importance for older adults to engage in a physically active lifestyle as it might serve as a preventive measure for driving safety.

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Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16101670 ◽

2019 ◽

Vol 16 (10) ◽

pp. 1670 ◽

Cited By ~ 4

Author(s):

Shervin Assari ◽

James Smith ◽

Mohsen Bazargan

Keyword(s):

Older Adults ◽

Gender Differences ◽

Los Angeles ◽

Social Relations ◽

Low Income ◽

Economically Disadvantaged ◽

African American Men ◽

Equation Modeling ◽

Men And Women ◽

Self Rated Health

Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations—a phenomenon known as “the sponge hypothesis.” However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.

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