Evaluation of a Short-Term Digital Group Intervention to Relieve Mental Distress and Promote Well-Being Among Community-Dwelling Older Individuals During the COVID-19 Outbreak: A Study Protocol

Older individuals are at an increased risk of experiencing adverse social and health consequences due to both the COVID-19 pandemic and the measures taken to manage it, such as social distancing. To promote community-dwelling older individuals' well-being during this time, the aims of the current project are to develop effective strategies in order (a) to increase older individuals' digital literacy, and (b) to help them acquire behavioral and cognitive skills that will improve their coping abilities with the stressful situation created as a result of the pandemic, as well as reducing adverse mental health effects. The project comprises an intervention arm that includes digital group sessions for older individuals meant to improve their digital literacy, promote their effective coping, and relieve their mental distress and loneliness. Subjects receive a short-term (seven sessions), twice-weekly, digitally guided group intervention through Zoom (a video conferencing app), and WhatsApp (instant messaging app). The wait list control-group participants receive twice-weekly telephone calls from a research assistant during a parallel period. Web-based questionnaires are filled in pre- and post-participation. The effectiveness of the intervention will be analyzed by comparing pre- and post-measures, between intervention and control groups. This protocol offers a model for helping to support vulnerable populations during the COVID-19 pandemic. However, it is applicable regardless of the outbreak of a global health crisis or the imposition of lockdown rules; in fact, it has the potential to contribute to the social inclusion of vulnerable populations during routine times as well as during emergencies. Furthermore, ideas for future expansion include the integration of multilingual facilitators in order to reach seniors from underserved minority groups in various social contexts, even across borders.

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Takes Two to Tango: Cognitive Impairment and Sexual Activity in Older Individuals and Dyads

The Journals of Gerontology Series B ◽

10.1093/geronb/gbab158 ◽

2021 ◽

Author(s):

Linda J Waite ◽

James Iveniuk ◽

Ashwin Kotwal

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Function ◽

Sexual Activity ◽

Social Life ◽

Well Being ◽

Community Dwelling ◽

Older Individuals ◽

Probit Regression ◽

Early Dementia

Abstract Objectives This paper examines the association between cognitive impairment, including mild cognitive impairment (MCI) and early dementia (ED), and sexual activity in a large, longitudinal sample of community-dwelling older adults. We focus here on sexual activity, which includes both sexual activity with a partner and masturbation. Methods We analyzed 3777 older individuals and members of 955 intimate dyads using the National Social Life, Health and Aging Project (2010 and 2015). We used ordered-probit regression, cross-lagged panels models, and probit regression. Results We find that older adults with cognitive limitations, either MCI or early dementia, are about as likely to be sexually active with a partner as those with normal cognitive function. This is the case both in the cross section and longitudinally. Both men and women with early dementia are less likely to have masturbated, however. Among married and cohabiting couples, we find no association between cognitive impairment in either the husband, the wife, or in both partners and their joint sexual activity. Women whose measured cognitive function is lower than their husband’s are less likely to report any masturbation. Discussion Sex with a partner, a fundamentally social activity, seems to be conserved in the face of cognitive limitation but masturbation, a solitary activity, does not. We argue that the intimate dyad plays an important role in conserving partnered sexual activity. Results can inform strategies to maintain sexual well-being of older adults with cognitive impairment and their partners as part of overall strategies to improve quality of life.

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Evaluation of the Reitman Centre CARERS program for supporting dementia family caregivers: a pre–post intervention study

International Psychogeriatrics ◽

10.1017/s1041610220004019 ◽

2021 ◽

pp. 1-12

Author(s):

Joel Sadavoy ◽

Sima Sajedinejad ◽

Mary Chiu

Keyword(s):

Family Caregivers ◽

Group Intervention ◽

Adult Child ◽

Cost Effective ◽

Skills Training ◽

Well Being ◽

Community Dwelling ◽

Rank Test ◽

Post Intervention ◽

People With Dementia

ABSTRACT Objectives: While family caregivers (CGs) of persons with dementia are cost-effective for the health system, this form of caregiving leads to disproportionate vulnerability to physical, mental, and social adverse health consequences among CGs. The study goal was to determine the effect of the Reitman Centre CARERS program on key outcomes in family CGs of people with dementia. The Reitman Centre CARERS program is an innovative, group psychotherapeutic skills training intervention based on integrated problem-solving techniques (PST), simulation learning, and group psychotherapy designed to address each CGs’ unique situation. Design: A quasi-experimental, non-randomized, pre–post evaluation, multiple groups, multisite trial. Setting: Multisite group intervention provided in community agencies and hospital-based locations. Participants: Spousal or adult child family CGs (n = 264) living in the community and providing care to community-dwelling family members with dementia. Measurement: CGs were assessed for depression (CES-D); stress (PSS); burden (12-item SZBI); role overload, mastery, caregiving competence, and role captivity (Perlin scales), coping (CISS – Coping Inventory for Stressful Situations), CG reactions to CR’s memory and behavioral symptoms (RMBPC). Care recipients (CRs) were assessed on basic and complex activities of daily living (Katz and Lawton). Paired t-tests and Wilcoxon signed-rank test were used for statistical analysis of both the whole group and a more compromised subgroup of CGs. Results: For the group as a whole, CGs showed significant positive change on post-intervention outcome measures of stress, depression, burden, competence, role captivity, overload, mastery, coping, and reaction to memory issues. The intervention showed especially robust effect sizes (ES) in more compromised CGs. These positive outcomes emerged despite a significant measured deterioration in CRs’ function. Conclusion: The CARERS program may be an effective multicomponent intervention to improve the well-being, functioning, and coping skills of dementia CGs.

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Short-Term Lifestyle Strategies for Sustaining Cognitive Status

BioMed Research International ◽

10.1155/2016/7405748 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Elizabeth P. Howard ◽

John N. Morris ◽

Knight Steel ◽

Kelley A. Strout ◽

Brant E. Fries ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Decline ◽

Older Adult ◽

Well Being ◽

Cognitive Status ◽

Community Dwelling ◽

Favorable Effect ◽

Adult Health ◽

Short Term ◽

One Year

Cognitive decline impacts older adults, particularly their independence. The goal of this project was to increase understanding of how short-term, everyday lifestyle options, including physical activity, help an older adult sustain cognitive independence. Using a secondary analysis of lifestyle choices, we drew on a dataset of 4,620 community-dwelling elders in the US, assessed at baseline and one year later using 2 valid and reliable tools, the interRAI Community Health Assessment and the interRAI Wellness tool. Decline or no decline on the Cognitive Performance Scale was the dependent variable. We examined sustaining one’s status on this measure over a one-year period in relation to key dimensions of wellness through intellectual, physical, emotional, social, and spiritual variables. Engaging in physical activity, formal exercise, and specific recreational activities had a favorable effect on short-term cognitive decline. Involvement with computers, crossword puzzles, handicrafts, and formal education courses also were protective factors. The physical and intellectual domains of wellness are prominent aspects in protection from cognitive decline. Inherent in these two domains are mutable factors suitable for targeted efforts to promote older adult health and well-being.

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Subjective well-being amongst community-dwelling elders: what determines satisfaction with life? Findings from the Dublin Healthy Aging Study

International Psychogeriatrics ◽

10.1017/s1041610211001360 ◽

2011 ◽

Vol 24 (2) ◽

pp. 316-323 ◽

Cited By ~ 35

Author(s):

Aine M. Ní Mhaoláin ◽

Damien Gallagher ◽

Henry O Connell ◽

A. V. Chin ◽

Irene Bruce ◽

...

Keyword(s):

Physical Activity ◽

Life Satisfaction ◽

Older People ◽

Successful Aging ◽

Healthy Aging ◽

Satisfaction With Life ◽

Well Being ◽

Community Dwelling ◽

Subjective Well Being ◽

Older Individuals

ABSTRACTBackground: Life satisfaction is a subjective expression of well-being and successful aging. Subjective well-being is a major determinant of health outcomes in older people. The aim of this study was to determine which factors predicted well-being in older people living in the community as measured by their satisfaction with life.Methods: The relationship between life satisfaction, as measured by the Life Satisfaction Index (LSI-A) and physical, cognitive and demographic variables was examined in 466 older people living in the community using a stepwise regression modelResults: Depression, loneliness, neuroticism, extraversion, recent participation in physical activity, age and self-reported exhaustion, were the independent predictors of life satisfaction in our elderly cohort.Conclusion: Subjective well-being, as measured by the Life Satisfaction Scale, is predicted by depression, loneliness, personality traits, recent participation in physical activity and self-reported exhaustion. The mental and emotional status of older individuals, as well as their engagement in physical activity, are as important as physical functionality when it comes to life satisfaction as a measure of well-being and successful aging. These areas represent key targets for intervention.

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Mental Distress and Human Rights Violations During COVID-19: A Rapid Review of the Evidence Informing Rights, Mental Health Needs, and Public Policy Around Vulnerable Populations

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.603875 ◽

2021 ◽

Vol 11 ◽

Author(s):

Muhammad Rahman ◽

Rabab Ahmed ◽

Modhurima Moitra ◽

Laura Damschroder ◽

Ross Brownson ◽

...

Keyword(s):

Mental Health ◽

Human Rights ◽

Vulnerable Populations ◽

Mental Distress ◽

Well Being ◽

Health Needs ◽

Rapid Review ◽

Human Rights Violations ◽

Mental Health Needs

Background: COVID-19 prevention and mitigation efforts were abrupt and challenging for most countries with the protracted lockdown straining socioeconomic activities. Marginalized groups and individuals are particularly vulnerable to adverse effects of the pandemic such as human rights abuses and violations which can lead to psychological distress. In this review, we focus on mental distress and disturbances that have emanated due to human rights restrictions and violations amidst the pandemic. We underscore how mental health is both directly impacted by the force of pandemic and by prevention and mitigation structures put in place to combat the disease.Methods: We conducted a review of relevant studies examining human rights violations in COVID-19 response, with a focus on vulnerable populations, and its association with mental health and psychological well-being. We searched PubMed and Embase databases for studies between December 2019 to July 2020. Three reviewers evaluated the eligibility criteria and extracted data.Results: Twenty-four studies were included in the systematic inquiry reporting on distress due to human rights violations. Unanimously, the studies found vulnerable populations to be at a high risk for mental distress. Limited mobility rights disproportionately harmed psychiatric patients, low-income individuals, and minorities who were at higher risk for self-harm and worsening mental health. Healthcare workers suffered negative mental health consequences due to stigma and lack of personal protective equipment and stigma. Other vulnerable groups such as the elderly, children, and refugees also experienced negative consequences.Conclusions: This review emphasizes the need to uphold human rights and address long term mental health needs of populations that have suffered disproportionately during the pandemic. Countries can embed a proactive psychosocial response to medical management as well as in existing prevention strategies. International human rights guidelines are useful in this direction but an emphasis should be placed on strengthening rights informed psychosocial response with specific strategies to enhance mental health in the long-term. We underscore that various fundamental human rights are interdependent and therefore undermining one leads to a poor impact on the others. We strongly recommend global efforts toward focusing both on minimizing fatalities, protecting human rights, and promoting long term mental well-being.

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MATCHING DIGITAL INTERVENTION AFFORDANCES WITH TASKS: THE CASE OF ZOOM AND WHATSAPP MENTAL HEALTH INTERVENTION FOR SENIORS DURING THE COVID-19 PANDEMIC

AoIR Selected Papers of Internet Research ◽

10.5210/spir.v2021i0.12265 ◽

2021 ◽

Author(s):

Daphna Yeshua-Katz ◽

Stav Shapira ◽

Limor Aharonson-Daniel ◽

A. Mark Clarfield ◽

Orly Sarid

Keyword(s):

Mental Health ◽

Group Intervention ◽

Text Messages ◽

Community Dwelling ◽

Older Individuals ◽

Media Richness Theory ◽

Rich Media ◽

The Media ◽

Technological Affordances ◽

Research And Design

During the first COVID-19 wave, we conducted a Zoom and WhatsApp digital group intervention that promoted community-dwelling older individuals’ mental health. Based on the media richness theory (MRT) and affordances approach, in this study we used netnography to explore how Zoom and WhatsApp technological affordances/constraints matched intervention tasks and increased intervention performance. We identified four Zoom and WhatsApp affordances: temporality, interactivity, multimediality, and portability. Empirically, our findings indicate how an information-rich media (i.e., high levels of multimediality) can be helpful in conducting complicated intervention tasks, whereas information-lean media (i.e., ongoing communication through text messages) can support simple tasks such as remote intervention management. Theoretically, our study expands on previous MRT media characteristics with the affordances approach and examines how the match between media affordances and task characteristics contributes to intervention performance. We offer recommendations for the research and design of future digital interventions.

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Positive health during the COVID-19 pandemic: a survey among community-dwelling older individuals in the Netherlands

BMC Geriatrics ◽

10.1186/s12877-021-02737-2 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

I. S. Moens ◽

L. J. van Gerven ◽

S. M. Debeij ◽

C. H. Bakker ◽

M. J. C. Moester ◽

...

Keyword(s):

The Netherlands ◽

Well Being ◽

Community Dwelling ◽

Living Alone ◽

Older Individuals ◽

Positive Health ◽

Six Dimensions ◽

Restrictive Measures ◽

Mental Well Being

Abstract Background Coronavirus Disease 2019 (COVID-19) reached the Netherlands in February 2020. To minimize the spread of the virus, the Dutch government announced an “intelligent lockdown”. Older individuals were urged to socially isolate completely, because they are at risk of a severe disease course. Although isolation reduces the medical impact of the virus, the non-medical impact should also be considered. Aim To investigate the impact of COVID-19 pandemic and associated restrictive measures on the six dimensions of Positive Health in community-dwelling older individuals living in the Netherlands, and to identify differences within subgroups. Methods In May/June 2020, community-dwelling older individuals aged ≥ 65 years completed an online survey based on Huber’s model of Positive Health. Positive Health was measured regarding the appreciation of the six dimensions (categorized as poor/satisfactory/excellent) and a comparison with a year before (categorized as decreased/unchanged/increased) using frequencies (%) and a chi-square test. Results 834 older individuals participated (51% women, 38% aged ≥ 76 years, 35% living alone, 16% self-rated poor health). Most respondents assessed their bodily functions, mental well-being and daily functioning as satisfactory, their meaningfulness and quality of life (QoL) as excellent, and their social participation as poor. 12% of the respondents reported a deterioration of 4–6 dimensions and 73% in 1–3 dimensions, compared to the past year. Deterioration was most frequently experienced in the dimension social participation (73%), the dimension mental well-being was most frequently improved (37%) and quality of life was in 71% rated as unchanged. Women more often observed a deterioration of 4–6 dimensions than men (15% vs. 8%, p = 0.001), and individuals with self-rated poor health more often than individuals with self-rated good health (22% vs. 10%, p < 0.001). Older individuals living alone experienced more frequently a decrease in meaningfulness compared to older individuals living together. Conclusion The COVID-19 pandemic and associated restrictive measures had a substantial impact on all six dimensions of Positive Health in community-dwelling older individuals, especially in women, respondents living alone and respondents with self-rated poor general health.

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HeART of Stroke: randomised controlled, parallel-arm, feasibility study of a community-based arts and health intervention plus usual care compared with usual care to increase psychological well-being in people following a stroke

BMJ Open ◽

10.1136/bmjopen-2017-021098 ◽

2019 ◽

Vol 9 (3) ◽

pp. e021098 ◽

Cited By ~ 3

Author(s):

Caroline Ellis-Hill ◽

Sarah Thomas ◽

Fergus Gracey ◽

Catherine Lamont-Robinson ◽

Robin Cant ◽

...

Keyword(s):

Usual Care ◽

Group Intervention ◽

Well Being ◽

Health Intervention ◽

Community Dwelling ◽

Community Based ◽

Psychological Well Being ◽

Health Group ◽

Arts And Health ◽

Randomised Controlled

IntroductionPeople often experience distress following stroke due to fundamental challenges to their identity.ObjectivesTo evaluate (1) the acceptability of ‘HeART of Stroke’ (HoS), a community-based arts and health group intervention, to increase psychological well-being; and (2) the feasibility of a definitive randomised controlled trial (RCT).DesignTwo-centre, 24-month, parallel-arm RCT with qualitative and economic components. Randomisation was stratified by centre and stroke severity. Participant blinding was not possible. Outcome assessment blinding was attempted.SettingCommunity.ParticipantsCommunity-dwelling adults ≤2 years poststroke recruited via hospital clinical teams/databases or community stroke/rehabilitation teams.InterventionsArtist-facilitated arts and health group intervention (HoS) (ten 2-hour sessions over 14 weeks) plus usual care (UC) versus UC.OutcomesThe outcomes were self-reported measures of well-being, mood, capability, health-related quality of life, self-esteem and self-concept (baseline and 5 months postrandomisation). Key feasibility parameters were gathered, data collection methods were piloted, and participant interviews (n=24) explored the acceptability of the intervention and study processes.ResultsDespite a low recruitment rate (14%; 95% CI 11% to 18%), 88% of the recruitment target was met, with 29 participants randomised to HoS and 27 to UC (57% male; mean (SD) age=70 (12.1) years; time since stroke=9 (6.1) months). Follow-up data were available for 47 of 56 (84%; 95% CI 72% to 91%). Completion rates for a study-specific resource use questionnaire were 79% and 68% (National Health Service and societal perspectives). Five people declined HoS postrandomisation; of the remaining 24 who attended, 83% attended ≥6 sessions. Preliminary effect sizes for candidate primary outcomes were in the direction of benefit for the HoS arm. Participants found study processes acceptable. The intervention cost an estimated £456 per person and was well-received (no intervention-related serious adverse events were reported).ConclusionsFindings from this first community-based study of an arts and health intervention for people poststroke suggest a definitive RCT is feasible. Recruitment methods will be revised.Trial registration numberISRCTN99728983.

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Functional Status, Meanings of Life Activities, and COVID-19 Related Disruptions among Disabled Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.3469 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 948-948

Author(s):

Meng-Hsuan Yu ◽

Shiau-Fang Chao

Keyword(s):

Older Adults ◽

Functional Status ◽

Well Being ◽

Community Dwelling ◽

Daily Routine ◽

Older Individuals ◽

Research Findings ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Participating in meaningful activities has been proven beneficial to the well-being of disabled older adults. However, social distancing policies and restrictions on public activities have been implemented since the outbreak of COVID-19 at the beginning of 2020 in Taiwan. These restrictions not only prevent older individuals from performing meaningful activities but also have actual impacts on their daily life. This study aims to elucidate the intervening role of meanings of life activities on the relationship between functional status and COVID-19 disruptions. Data were collected from a sample of 526 community-dwelling older adults with disabilities in Taiwan between April and July, 2020. Utilizing Multiple Regression Analysis, the research findings were as follows. First, participants with better functional status experienced more COVID-19 related disruptions to their daily routine. In the meantime, they also valued their life activities as more meaningful than those with worse functional status. Second, higher levels of meanings in performing life activities also positively related to COVID-19 disruptions. Third, meanings of life activities fully mediated the relationship between functional status and COVID-19 disruptions. That is, disabled older individuals with better functional status may experience more COVID-19 related disruptions because their accessibility to meaningful activities was limited. Since preventive approaches to control the spread are necessary during COVID-19 epidemic, efforts should be made to sustain meaningful life activities participation among disabled older adults. Based on the findings of this study, this would be especially critical to the well-being of more capable older individuals with disabilities during the pandemic.

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Perceived Voice Disorders in Older Adults and Impact on Social Interactions

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00059 ◽

2021 ◽

pp. 1-8

Author(s):

Connie K. Porcaro ◽

Clare Singer ◽

Boris Djokic ◽

Ali A. Danesh ◽

Ruth Tappen ◽

...

Keyword(s):

Older Adults ◽

Social Interactions ◽

Social Engagement ◽

Leisure Activities ◽

Treatment Strategies ◽

Voice Disorders ◽

Community Dwelling ◽

Vocal Performance ◽

Older Individuals ◽

Cross Sectional

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

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