Social Isolation and Psychological Distress Among Older Adults Related to COVID-19: A Narrative Review of Remotely-Delivered Interventions and Recommendations

The COVID-19 pandemic is associated with several short- and long-term negative impacts on the well-being of older adults. Physical distancing recommendations to reduce transmission of the SARS-CoV2-19 virus increase the risk of social isolation and loneliness, which are associated with negative outcomes including anxiety, depression, cognitive decline, and mortality. Taken together, social isolation and additional psychological impacts of the pandemic (e.g., worry, grief) underscore the importance of intervention efforts to older adults. This narrative review draws upon a wide range of evidence to provide a comprehensive overview of appropriate remotely-delivered interventions for older adults that target loneliness and psychological symptoms. These include interventions delivered by a range of individuals (i.e., community members to mental health professionals), and interventions that vary by implementation (e.g., self-guided therapy, remotely-delivered interventions via telephone or video call). Recommendations to overcome barriers to implementation and delivery are provided, with consideration given to the different living situations.

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Experiences with Technology Amongst an International Sample of Older Adults: Results from a Qualitative Interpretive Meta-Synthesis

The British Journal of Social Work ◽

10.1093/bjsw/bcab040 ◽

2021 ◽

Author(s):

Vivian J Miller ◽

Erin M Roark ◽

Noelle L Fields ◽

Courtney Cronley

Keyword(s):

Older Adults ◽

Social Work ◽

Social Isolation ◽

Technology Use ◽

Well Being ◽

Information And Communications Technology ◽

World Health ◽

Subjective Well Being ◽

Negative Impacts ◽

Nuanced Understanding

Abstract Identifying and implementing effective strategies to combat social exclusion and isolation is critical, given that eradicating social isolation has been identified as one of the social work profession’s main goals. Training older adults to use information and communications technology (ICT) effectively may be an appropriate intervention to combat and mitigate the negative impacts of social isolation within the aging population. ICT has demonstrated promise with older adults, with research demonstrating that older adults with higher technology use report better self-reported physical health and subjective well-being. Given this promise, the authors of this study seek to create more nuanced understanding of the experience of ICT usage, as told by an international sample of older adults using a qualitative interpretive meta-synthesis (QIMS). Using the QIMS methodology paired with phenomenological reduction, the authors synthesised nine (N = 9) qualitative studies through the lens of the World Health Organization’s age-friendly domains. This process resulted in three overarching themes that describe older adults’ experiences engaging with technology: ‘desire for empowerment’, ‘connection’ and ‘aging well’. Findings from this study highlight overall benefits of technology use among older adults aging in the community. This study concludes with implications for social work research and practice.

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Social Telepresence Robots: A Narrative Review of Experiments Involving Older Adults before and during the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073597 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3597

Author(s):

Baptiste Isabet ◽

Maribel Pino ◽

Manon Lewis ◽

Samuel Benveniste ◽

Anne-Sophie Rigaud

Keyword(s):

Older Adults ◽

Elderly People ◽

Social Isolation ◽

Social Relationships ◽

Well Being ◽

Narrative Review ◽

Multidimensional Analysis ◽

Assessment Model ◽

Easy Access ◽

Telepresence Robots

Social isolation is a common phenomenon among the elderly. Retirement, widowhood, and increased prevalence of chronic diseases in this age group lead to a decline in social relationships, which in turn has adverse consequences on health and well-being. The coronavirus COVID-19 crisis worsened this situation, raising interest for mobile telepresence robots (MTR) that would help create, maintain, and strengthen social relationships. MTR are tools equipped with a camera, monitor, microphone, and speaker, with a body on wheels that allows for remote-controlled and sometimes autonomous movement aiming to provide easy access to assistance and networking services. We conducted a narrative review of literature describing experimental studies of MTR involving elderly people over the last 20 years, including during the COVID-19 period. The aim of this review was to examine whether MTR use was beneficial for reducing loneliness and social isolation among older adults at home and in health and care institutions and to examine the current benefits and barriers to their use and implementation. We screened 1754 references and included 24 research papers focusing on the usability, acceptability, and effectiveness of MTR. News reports on MTR use during the COVID-19 period were also examined. A qualitative, multidimensional analysis methodology inspired by a health technology assessment model was used to identify facilitating and limiting factors and investigate if and how MTR could reduce social isolation in elderly people. Reviewed studies provide encouraging evidence that MTR have potential in this regard, as experiments report positive feedback on MTR design and core functionalities. However, our analysis also points to specific technical, ergonomic, and ethical challenges that remain to be solved, highlighting the need for further multidimensional research on the design and impact of MTR interventions for older adults and building on new insights gained during the COVID-19 pandemic.

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Video Calls for Older Adults: A Narrative Review of Experiments Involving Older Adults in Elderly Care Institutions

Frontiers in Public Health ◽

10.3389/fpubh.2021.751150 ◽

2022 ◽

Vol 9 ◽

Author(s):

Bérangère Naudé ◽

Anne-Sophie Rigaud ◽

Maribel Pino

Keyword(s):

Older Adults ◽

Information And Communication Technologies ◽

Social Isolation ◽

Elderly Care ◽

Family Members ◽

Well Being ◽

Narrative Review ◽

Remote Communication ◽

Related Factors ◽

Geriatric Settings

Social isolation in geriatric institutions is a real threat to older adults' (OAs) well-being. Visits from family members, when they are not impacted by geographical distance or illness, sometimes fail to provide sufficient opportunities for social connectedness and interaction to prevent and/or combat OAs' loneliness and social isolation. Information and Communication Technologies (ICTs) offer promising solutions to this problem. Video calls provide a quick and convenient way for remote communication between OAs and their families, and a complement to face-to-face visits in geriatric settings. Over the last months, during the several confinements imposed to stop the transmission of COVID-19 over the world, several care homes and long-care facilities have equipped themselves with laptops, tablets and video call applications to help OAs remain in contact with their relatives. However, numerous technical and human-related factors may hinder the use of video calls in these settings. The complexity of technological devices, as well as OAs limited digital skills, low confidence and experience in the use of technology are some examples. Furthermore, the specific context of use and the required implication of multiple actors (care professionals, family members) should also be considered when examining the use and implementation of video calls in geriatric institutions. We conducted a narrative review of literature describing the use of video calls in geriatric institutions between 2000 and 2021, especially because of the little information related to OAs' use of video calls in geriatric settings. One thousand one hundred ninety-seven references were screened and 15 studies focusing on the usability, acceptability and effectiveness of video calls were included. A qualitative, deductive thematic analysis inspired by a Health Technology Assessment (HTA) multidimensional model was used to identify barriers, enablers and solutions to video calls implementation in geriatric institutions. The results from the HTA-based analysis provide encouraging evidence for the feasibility of video call use in geriatric settings, and its efficacy on reducing social isolation among residents. However, numerous technical, human-related, ethical and organizational barriers persist and should be addressed in future works. The present analysis has also allowed the identification of potential solutions to overcome these barriers, which are discussed in this publication.

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Social connection as a public health adaptation to extreme heat events

Can J Public Health ◽

10.17269/s41997-020-00309-2 ◽

2020 ◽

Vol 111 (6) ◽

pp. 876-879 ◽

Cited By ~ 1

Author(s):

Amani Kafeety ◽

Sarah B. Henderson ◽

Amy Lubik ◽

Jesse Kancir ◽

Tom Kosatsky ◽

...

Keyword(s):

Public Health ◽

Older Adults ◽

Social Isolation ◽

Well Being ◽

Extreme Heat ◽

Public Health Issue ◽

Social Connection ◽

Extreme Heat Events ◽

Wide Range ◽

Heat Events

AbstractClimate change is an increasingly important public health issue, reflected in morbidity and mortality outcomes during extreme heat events. At the same time, the harms of social isolation with respect to a wide range of health outcomes are becoming better understood. Given that older adults are at higher risk during hot weather and at higher risk of social isolation, they are among those at highest risk for adverse impacts of extreme heat events. While specific strategies to reduce heat exposure have been described in the literature and promoted in public health practice, these may not be readily available to socially isolated older adults. As such, it is crucial to identify key approaches to address risk due to social isolation in the aging population, and to acknowledge their limitations and barriers. Interventions rooted in social connection, a concept widely applied in interventions for public health and social well-being, should be applied as a tool for adaptation to extreme heat events.

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Assessing Emotional Well-Being as a Result of Quarantining During the COVID-19 Pandemic (Preprint)

10.2196/preprints.24637 ◽

2020 ◽

Author(s):

Andrea Breanne Wilson ◽

Will Althoff

Keyword(s):

Social Interaction ◽

Negative Affect ◽

Social Isolation ◽

Well Being ◽

Positive And Negative Affect ◽

Negative Effect ◽

Negative Impacts

UNSTRUCTURED Emotional well-being can be negatively impacted by lack of social interaction. This study examined the effects of social isolation on emotional well-being. Respondents filled out a weekly survey for a period of 10 weeks, reporting their positive and negative affect (PANAS-X) and the effects of quarantine on their emotional well-being. Results indicate that quarantining had a negative effect on respondents’ emotional well-being. Activites and outings, suggested by the CDC, could potentially decrease the negative impacts of quarantine.

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The Effects of Technological Interventions on Social Participation of Community-Dwelling Older Adults with and without Dementia: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10112308 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2308

Author(s):

Pascale Heins ◽

Lizzy M. M. Boots ◽

Wei Qi Koh ◽

An Neven ◽

Frans R. J. Verhey ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Social Isolation ◽

Social Participation ◽

Methodological Quality ◽

Well Being ◽

Community Dwelling ◽

Cochrane Library ◽

Technological Interventions ◽

Community Dwelling Older Adults

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.

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Virtual Body Ownership Illusions for Mental Health: A Narrative Review

Journal of Clinical Medicine ◽

10.3390/jcm10010139 ◽

2021 ◽

Vol 10 (1) ◽

pp. 139

Author(s):

Marta Matamala-Gomez ◽

Antonella Maselli ◽

Clelia Malighetti ◽

Olivia Realdon ◽

Fabrizia Mantovani ◽

...

Keyword(s):

Mental Health ◽

Clinical Care ◽

Well Being ◽

Narrative Review ◽

Future Research ◽

Body Ownership ◽

Surrounding Environment ◽

Wide Range ◽

Clinical Conditions ◽

Virtual Body

Over the last 20 years, virtual reality (VR) has been widely used to promote mental health in populations presenting different clinical conditions. Mental health does not refer only to the absence of psychiatric disorders but to the absence of a wide range of clinical conditions that influence people’s general and social well-being such as chronic pain, neurological disorders that lead to motor o perceptual impairments, psychological disorders that alter behaviour and social cognition, or physical conditions like eating disorders or present in amputees. It is known that an accurate perception of oneself and of the surrounding environment are both key elements to enjoy mental health and well-being, and that both can be distorted in patients suffering from the clinical conditions mentioned above. In the past few years, multiple studies have shown the effectiveness of VR to modulate such perceptual distortions of oneself and of the surrounding environment through virtual body ownership illusions. This narrative review aims to review clinical studies that have explored the manipulation of embodied virtual bodies in VR for improving mental health, and to discuss the current state of the art and the challenges for future research in the context of clinical care.

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Depression and Psychological Well-Being as Distinct Constructs: Mutually Exclusive Associations With Biomarker

Innovation in Aging ◽

10.1093/geroni/igaa057.808 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 251-251

Author(s):

Kheng Siang Ted Ng ◽

Shu Cheng Wong ◽

Glenn Wong ◽

Ee Heok Kua ◽

Anis Larbi ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Depressive Symptoms ◽

Factor Score ◽

Well Being ◽

Community Dwelling ◽

The Other ◽

Factor Scores ◽

Psychological Well Being ◽

Wide Range

Abstract Despite increasing emphasis on assessing the mental health of older adults, there has been inconclusive evidence on whether depression and psychological well-being (PWB) are fundamentally distinct constructs or representations of the opposite ends of the mental health spectrum. To instantiate either hypothesis, investigation of the associations between mental health scales and biomarkers have been proposed. First, we assessed depressive symptoms and PWB in community-dwelling older adults (N=59, mean age=67) using the Self-Rating Depression Scale (SDS) and Ryff’s Scale of PWB (comprising six sub-scales). We measured a wide range of immune markers employing ELISA and flow cytometry. Subsequently, we used principal component analysis (PCA) to aggregate and derived biomarker factor scores. Lastly, multiple linear regressions were performed to examine the associations between the scales and the derived biomarker factor scores, controlling for covariates. PCA extracted six biomarker factors. Biomarker factor score 1 was significantly associated with PWB (β=-0.029, p=0.035) and the PWB sub-scale, self-acceptance (β=-0.089, p=0.047), while biomarker factor score 4 was significantly associated with the PWB sub-scale, purpose in life (β=-0.087, p=0.025). On the other hand, biomarker factor 6 was significantly associated with SDS (β=-0.070, p=0.008). There were mutually- exclusive associations between the scales with biomarker factor scores, supporting the hypothesis of distinct constructs. Our findings expanded the biomarkers of depression and PWB, deepening understanding of the biological underpinnings of depressive symptoms and PWB. These findings have implications in field work, since researchers could not infer one construct from the other, the examination of both constructs are essential.

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SENIOR FRIENDLY PACKAGING AND PRODUCT TESTING: FEEDBACK FROM OLDER CONSUMERS

Innovation in Aging ◽

10.1093/geroni/igz038.2380 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S639-S640

Author(s):

Lisa A Hollis-Sawyer ◽

Alison O’Neil

Keyword(s):

Older Adults ◽

Well Being ◽

Evaluation Study ◽

The United States ◽

Consumer Products ◽

Color Contrast ◽

Product Testing ◽

Package Design ◽

Age Related ◽

Wide Range

Abstract By 2050, older adults ages 65 or older will account for 83.7 million people in the U.S. population (An Aging Nation: The Older Population in the United States, 2014). It is imperative that products and technologies are designed to accommodate age-related changes that older adults are likely to experience. Given this population surge of older adults, there is a growing interest in identifying consumer products that are usable for older adults or “senior friendly.” Senior-friendly product testing (e.g., Senior Select®) focuses on the usability of various health and consumer products targeted to people with diminishment of any of the following: hearing, vision, taste, touch, smell, mobility & dexterity and /or mental acuity. A usability evaluation study was conducted in three senior living communities located in the Atlanta area. Twenty-nine participants ranged in age from 66 years old to 102 years old. Participants were shown a snack bar product and then asked to use the product themselves to perform a series of prepared tasks. After interacting with the product, participants were asked to share any comments that they had concerning the product. Issues of color contrast between the main packaging and the pull tab, easy of gripping and tearing the wrapper, the labeling of the nutrition information, and the package labeling (should refer to “adult” snack) were reported. Many respondents suggested that senior-friendly package design relates to their health and well-being. Implications toward a wide range of products for older adults of varying ability levels will be discussed.

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SOCIAL ISOLATION AND FALLS RISK AMONG COMMUNITY DWELLING OLDER ADULTS: THE MEDIATING ROLE OF DEPRESSION

Innovation in Aging ◽

10.1093/geroni/igz038.1078 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S293-S293

Author(s):

Jeffrey Burr ◽

Lien Quach

Keyword(s):

Social Support ◽

Older Adults ◽

Social Isolation ◽

Perceived Social Support ◽

Well Being ◽

Community Dwelling ◽

Outcome Variable ◽

Falls Risk ◽

Risk Of Falls ◽

Perceived Social Isolation

Abstract Relatively little is known about the relationship between social isolation and the risk of falls among older adults. Yet, a considerable amount of research demonstrates that lack of sufficient social relationships, broadly defined, represents a modifiable risk factor for many indicators of well-being in later life. This study examines the association between two types of social isolation and the risk of falls. The study also examines whether depression mediates the association between social isolation and risk of falls. Longitudinal data from the Health and Retirement Study (2006-2012) were collected from community-dwelling participants aged 65 and older (N=8,464). The outcome variable was number of falls self-reported over the observation period. Independent variables included perceived isolation (feeling lonely, perceptions of social support), social disconnectedness (e.g., having no friends or relatives living nearby, living alone), and number of depressive symptoms. Results from regression models indicated that social disconnectedness was associated with a 5% increase in the risk of falls (IRR=1.05, 95% CI=1.01-1.09). Perceived social support was associated with a 21% increase in the risk of falls; when examined together, perceived social support and loneliness were associated with a combined 37% increase in falls risk. Depression was associated with a 47% increase in falls. Depression mediated the association between perceived isolation and falls. Further, perceived isolation mediated the association between social disconnectedness and falls. Reducing perceived social isolation and social disconnectedness may be an avenue for designing interventions to reduce the risk of falls, especially for older adults with depression.

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