Social Isolation and Falls Risk: Lack of Social Contacts Decreases the Likelihood of Bathroom Modification Among Older Adults With Fear of Falling

Fall prevention strategies exist, but little is known about factors that influence whether they are used. We assessed whether social isolation modifies the association between fear of falling (FOF) and bathroom environmental modification. Data were included from 2858 Medicare beneficiaries in the National Health and Aging Trends Study. FOF and social isolation were assessed at baseline (2011); new bathroom modifications were assessed 1-year post-baseline. Social network size was dichotomized as any versus no social contacts. Logistic regression assessed associations between FOF and bathroom modification. Effect modification between FOF and social isolation was assessed with multiplicative interaction terms. FOF was associated with increased odds of bathroom modification. We observed a statistically significant interaction between FOF and social isolation ( p = 0.03). Among those with no social contacts, FOF was associated with reduced odds bathroom modification that did not reach statistical significance (OR 0.5, 95% CI 0.2–1.3).

Aging LGBT Adults’ Access to Social Resources According to LGBT Identity and Sociodemographics

Research suggests that social resources positively influence the health and well-being of lesbian, gay, bisexual, and transgender (LGBT) aging adults, but their access to social resources may vary according to LGBT identity. Using data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (N=2,536), multivariate models tested how access to social resources varied by LGBT identity and whether the effect of LGBT identity showed additional variations by sociodemographic characteristics (i.e., age and education) among aging LGBT adults. Lesbian respondents had larger social networks than gay respondents, while gay respondents had smaller networks than transgender respondents. Lesbian respondents had more social support and community belonging than other identity groups. Bisexual male respondents and transgender respondents had less support than gay respondents and bisexual male respondents reported less community belonging than gay respondents. Education and age moderated the association between LGBT identity and social support. Findings highlight the importance of considering social support separately from social network size with the understanding that large social networks do not necessarily provide ample social support and this distinction was particularly relevant for transgender respondents who had larger social networks, but less social support than gay respondents. Results also suggest that feelings of LGBT community belonging vary among LGBT identity groups. Health and human service professionals should not only consider the sexual and gender identity of their aging LGBT clients, but also consider the clients’ additional sociodemographic characteristics when assessing their access to social resources.

Correlates of Perceived Stress Among Community-Dwelling Older African Americans Without Dementia

The purpose of this study was to identify correlates of perceived stress among older African Americans without dementia. We grouped correlates into four levels – environmental, sociocultural, behavioral, and biological – guided by the National Institute on Aging’s (NIA) Health Disparities Research Framework. We performed a cross-sectional data analysis with the Minority Aging Research Study using ordinal logistic regression analyses. Participants were 722 African Americans without dementia [mean age = 73.61 years (SD=6.33)]. Correlates from environmental (e.g., larger life space), sociocultural (e.g., larger social network size), behavioral (e.g., more purpose in life), and biological (e.g., higher global cognition) levels were associated with lower odds of having greater levels of perceived stress. Perceived stress was associated with correlates from every level. Future research is needed to examine how changes in these correlates may be related to perceived stress in older African Americans.

Loneliness During COVID-19 and Modes of Social Contact Use Among Older Adults

Due to social distancing and isolation recommendations, COVID-19 resulted in older adults’ greater reliance on technology to contact friends and families. While the mental health of older adults during COVID-19 has been well explored, less is known about how changes in modes and frequency of social contact is associated with loneliness. Using the National Health and Aging Trends Study COVID-19 data, this study assessed how the frequency of varying modes of contact (e.g., phone/email/text, in-person visits, videocalls) during the pandemic was associated with feelings of loneliness during COVID-19 among community-dwelling Medicare beneficiaries (n = 2149). Participants were asked if they felt lonely “more often,” “less often,” or “about the same” compared to before the outbreak started. Multinomial regression analyses indicated that, compared to those who reported daily in-person visits, the odds of having more feelings of loneliness as compared to about the same as pre-COVID-19 was significantly higher among those who reported having in-person visits a few times (OR=2.17,CI=1.08-4.36), at least once (OR=2.37,CI=1.11-5.04), and never/less than once a week (OR=3.37, CI=1.59-7.16) while controlling for demographics, household, and social network size. Compared to daily use, use of phone/email/text at least once (OR=0.44, CI=0.201-0.965) or a few times (OR=0.76,CI=0.58-0.99) a week was associated with lower odds of reporting more feelings of loneliness versus about the same. Results suggest that greater use of technology that promote social engagement improves social connectedness and decreases COVID-19 related loneliness among older adults, and highlights the importance of older adults’ access to technology, including reliable internet.

Social Support, Isolation, Loneliness, and Health Among Older Adults in the PRISM Randomized Controlled Trial

Objectives: Social isolation and loneliness are serious public health issues given the association with negative physical, mental; and cognitive health outcomes and increased risk for mortality. Due to changes in life circumstances many aging adults are socially isolated and experience loneliness. We examined the relationships among four correlated but distinct constructs: social network size, social support, social isolation, and loneliness as they relate to indices of health and wellbeing among diverse subpopulations of older adults. Guided by WHO’s International Classification of Functioning, Disability and Health (ICF) we also examined factors that predict loneliness and social isolation.Methods: Analyses of baseline data from sample of older adults who participated in an intervention trial that examined the beneficial effects of a software system designed to support access to resources and information, and social connectivity. Participants included 300 individuals aged 65–98, who lived alone, were primarily of lower socio-economic status and ethnically diverse. Participants completed a demographics questionnaire, self-report measures of health, depression, social network size, social support, and loneliness.Results: Loneliness was strongly associated with depression and self-ratings of health. In turn, greater social isolation and less social support were associated with greater loneliness. Social isolation was associated with depression and lower self-ratings of health. The association between social isolation and health was mediated by loneliness. Individuals in the older cohorts (80+) reported less social support. With respect to loneliness, having a smaller social network, more functional limitations, and limitations in engaging meaningful activities was associated with higher levels of loneliness and greater social isolation.Conclusion: The findings underscore the importance of social connectively to wellbeing for older adults and suggest that those in the older cohorts, who have a small social network, and with greater physical and functional impairments may be particularly vulnerable to being socially isolated and lonely. The findings provide guidance for future interventions. In this regard, we discuss how Information and Communication Technologies (ICTs) may be used to promote social connectivity and engagement. Strategies to make the usability and availability of these applications for aging adults are highlighted.

The Moderating Role of Social Network Size on Social Media Use and Self-Esteem: An Evolutionary Mismatch Perspective

Existing meta-analyses have shown that the relationship between social media use and self-esteem is negative, but at very small effect sizes, suggesting the presence of moderators that change the relationship between social media use and self-esteem. Employing principles from social comparison and evolutionary mismatch theories, we propose that the social network sizes one has on social media play a key role in the relationship between social media use and self-esteem. In our study (N = 123), we showed that social media use was negatively related to self-esteem, but only when their social network size was within an evolutionarily familiar level. Social media use was not related to self-esteem when people’s social networks were at evolutionarily novel sizes. The data supported both social comparison and evolutionary mismatch theories and elucidated the small effect size found for the relationship between social media use and self-esteem in current literature. More critically, the findings of this study highlight the need to consider evolutionarily novel stimuli that are present on social media to better understand the behaviors of people in this social environment.

INTERNET USE AND MENTAL HEALTH IN AFRICA AND INDIA

Prior research has shown that mental health in urban slums is associated with the a share number of older individuals in personal networks. This presentation will examine the extent to which that association is mediated through Internet and social media use. We conducted face to face interviews with residents (minimum 18 years) in two high density, low income areas of Accra (West Africa) and Trivandrum (Kerala, India), where local teams have conducted repeated studies of personal networks since 1994. Our preliminary results show that mobile phones are primary way in which respondents communicate with members of their core networks. Further preliminary results show that while research in high income areas has generally shown the importance of larger networks for positive mental health, our analysis of urban slums reveals a different pattern. First, there is no general association of larger networks with reduced symptoms of anxiety and depression. Second, one particular group of relationships is strongly associated with depression and anxiety: ties with older individuals. The questions we explore are: (1) To what extent are indicators of mental health related to indicators of Internet and social media usage? (2) To what extent are indicators of mental health related to indicators of social network size and composition? (3) To what extent are indicators of Internet and social media usage related to indicators of indicators of social network size and composition?

Examining Social Networks in Older Adults: What Predicts Communicative Participation?

Purpose Social isolation is linked to cognitive decline and depression, which can be risk factors for developing dementia. The purpose of this study was to determine which of a variety of factors were associated with communicative participation as measured by social network size. Method Three hundred thirty-seven adults aged 65 years or older were administered assessments to evaluate social network size, cognition, hearing handicap, and quality of communicative participation. Results Cognition, education, living setting, and quality of communication life were associated to varying degrees with the construct of communicative participation as measured by social network size. Conclusion Assessment of these variables, along with early identification of cognitive decline, could play an important role in identifying elderly individuals at risk for limitations in communicative participation and associated consequences.