What Could Interfere with a Good Night’s Sleep? The Risks of Social Isolation, Poor Physical and Psychological Health among Older Adults in China

This study provides one of the first population-based investigations of the longitudinal association between social isolation and sleep difficulty among older adults in China. We analyzed three waves of longitudinal data from the China Longitudinal Aging Social Survey (2014–2018), in which 8456 respondents contributed 16,156 person-year observations. Results from multilevel logistic regression models showed that social isolation was related to a higher risk of sleep difficulty. We also found that socially isolated older adults were more likely to report higher levels of depressive symptoms, a greater prevalence of loneliness and pain, and more chronic diseases compared to their socially integrated counterparts, which in turn increased their risks of sleep difficulty. Moreover, socially isolated older adults with chronic diseases were particularly vulnerable to the risk of sleep difficulty. These findings provide helpful guidance for policymakers and practitioners to design effective intervention strategies to help older adults with sleep problems.

Social isolation induces neuroinflammation and microglia overactivation, while dihydromyricetin prevents and improves them

Background Anxiety disorders are the most prevalent mental illnesses in the U.S. and are estimated to consume one-third of the country’s mental health treatment cost. Although anxiolytic therapies are available, many patients still exhibit treatment resistance, relapse, or substantial side effects. Further, due to the COVID-19 pandemic and stay-at-home order, social isolation, fear of the pandemic, and unprecedented times, the incidence of anxiety has dramatically increased. Previously, we have demonstrated dihydromyricetin (DHM), the major bioactive flavonoid extracted from Ampelopsis grossedentata, exhibits anxiolytic properties in a mouse model of social isolation-induced anxiety. Because GABAergic transmission modulates the immune system in addition to the inhibitory signal transmission, we investigated the effects of short-term social isolation on the neuroimmune system. Methods Eight-week-old male C57BL/6 mice were housed under absolute social isolation for 4 weeks. The anxiety-like behaviors after DHM treatment were examined using elevated plus-maze and open field behavioral tests. Gephyrin protein expression, microglial profile changes, NF-κB pathway activation, cytokine level, and serum corticosterone were measured. Results Socially isolated mice showed increased anxiety levels, reduced exploratory behaviors, and reduced gephyrin levels. Also, a dynamic alteration in hippocampal microglia were detected illustrated as a decline in microglia number and overactivation as determined by significant morphological changes including decreases in lacunarity, perimeter, and cell size and increase in cell density. Moreover, social isolation induced an increase in serum corticosterone level and activation in NF-κB pathway. Notably, DHM treatment counteracted these changes. Conclusion The results suggest that social isolation contributes to neuroinflammation, while DHM has the ability to improve neuroinflammation induced by anxiety.

Resident loneliness, social isolation and unplanned emergency department visits from supportive living facilities: a population-based study in Alberta, Canada

Background Supportive living (SL) facilities are intended to provide a residential care setting in a less restrictive and more cost-effective way than nursing homes (NH). SL residents with poor social relationships may be at risk for increased health service use. We describe the demographic and health service use patterns of lonely and socially isolated SL residents and to quantify associations between loneliness and social isolation on unplanned emergency department (ED) visits. Methods We conducted a retrospective cohort study using population-based linked health administrative data from Alberta, Canada. All SL residents aged 18 to 105 years who had at least one Resident Assessment Instrument-Home Care (RAI-HC) assessment between April 1, 2013 and March 31, 2018 were observed. Loneliness and social isolation were measured as a resident indicating that he/she feels lonely and if the resident had neither a primary nor secondary caregiver, respectively. Health service use in the 1 year following assessment included unplanned ED visits, hospital admissions, admission to higher levels of SL, admission to NH and death. Multivariable Cox proportional hazard models examined the association between loneliness and social isolation on the time to first unplanned ED visit. Results We identified 18,191 individuals living in Alberta SL facilities. The prevalence of loneliness was 18% (n = 3238), social isolation was 4% (n = 713). Lonely residents had the greatest overall health service use. Risk of unplanned ED visit increased with loneliness (aHR = 1.10, 95% CI: 1.04–1.15) but did not increase with social isolation (aHR = 0.95, 95% CI: 0.84–1.06). Conclusions Lonely residents had a different demographic profile (older, female, cognitively impaired) from socially isolated residents and were more likely to experience an unplanned ED visit. Our findings suggest the need to develop interventions to assist SL care providers with how to identify and address social factors to reduce risk of unplanned ED visits.

COVID-19-Related Lifestyle Changes among Community-Dwelling Older Adult Day-Care Users: A Qualitative Study

In Japan, the community-based comprehensive care system is an important initiative. The purpose of this study was to understand COVID-19-related lifestyle changes experienced by older adults who lived in communities and used day-care services. Using a qualitative inductive research method, semi-structured interviews were conducted with 13 older adults who used day-care services in Kyoto City, which assessed lifestyle changes before and after the spread of COVID-19 during March–April 2021. The extracted lifestyle change codes were classified into six categories and 16 subcategories. The data revealed that older adults felt socially isolated and experienced multiple changes in their lives, including limited leisure activities, changes in roles, decreased interpersonal interaction with family and acquaintances, poor diet and sleep quality, and reduced attention to personal appearance and grooming. The findings suggest that during COVID-19, older adults had difficulty adapting to the various changes in their lives and showed a decline in physical and mental functioning. Thus, it is important for day-care facilities to create sustainable spaces in response to the various care needs of community-dwelling older adults whose lifestyles have changed as a result of the COVID-19 situation.

Reduced older male presence linked to increased rates of aggression to non-conspecific targets in male elephants

Males in many large mammal species spend a considerable portion of their lives in all-male groups segregated from females. In long-lived species, these all-male groups may contain individuals of vastly different ages, providing the possibility that behaviours such as aggression vary with the age demographic of the social environment, as well as an individual's own age. Here, we explore social factors affecting aggression and fear behaviours in non-musth male African elephants ( Loxodonta africana ) aggregating in an all-male area. Adolescent males had greater probabilities of directing aggressive and fearful behaviours to non-elephant targets when alone compared to when with other males. All males, regardless of age, were less aggressive towards non-elephant targets (e.g. vehicles and non-elephant animals) when larger numbers of males from the oldest age cohort were present. The presence of older males did not influence the probability that other males were aggressive to conspecifics or expressed fearful behaviours towards non-elephant targets. Older bulls may police aggression directed towards non-elephant targets or may lower elephants’ perception of their current threat level. Our results suggest male elephants may pose an enhanced threat to humans and livestock when adolescents are socially isolated, and when fewer older bulls are nearby.

A Psychodrama Intervention to Loneliness Due to COVID-19

Loneliness as a psychological state is affective and cognitive discomfort or uneasiness from being or perceiving oneself to be alone or otherwise solitary. Since the beginning of the pandemic, people stayed at home, afraid of contracting COVID-19. As youths followed lectures via the internet for long hours without physical participation, they became more and more withdrawn and socially isolated. This study explores psychodrama as an intervention to reduce loneliness in university students. COVID-19 pandemic durations seemed to be caused loneliness for all people. The short-version of the ULCA loneliness scale was applied to 358 university students. 24 students were selected for the study based on their higher scores on the assessment. These students also accepted that COVID-19 negatively affected their loneliness state. The average age of participants was 21 years old, and no one was younger than 19 years old. Randomly they were divided into two groups as experimental and controlling with equal representation of number. The experimental group joined 15 weeks of psychodrama groups for 90 minutes each week. All sessions were held with via internet video platform meeting program. In psychodrama method of psychotherapy, clients enacted their concerns to achieve new insight about themselves and others. The psychodrama program started with introducing group participants and expression of why they are in the group to each other. The group was guided with an experienced group leader. With the techniques of psychodrama such as warmup, mirror, doubling, and role reversal, participants self-disclosed their current moods. K-square statistical analyses suggested that the group of university students who joined psychodrama overcame their loneliness. Education policy makers should bear in mind that today’s Covid-19 society suffers from psychological treatment deficits in the area of loneliness. Group action methods should be taken immediately. Group guidance, counseling, and drama in education and psychodrama can be useful for students to cope with problems resulting from of COVID-19. Youths truly need to share their suffering with professionals. Preventive guidance activities should be given importance in schools.

VA Compassionate Contact Corps: A Phone-Based Intervention for Veterans Interested In Speaking With Peers

The VA Voluntary Service has developed and implemented a new social prescription program called Compassionate Contact Corps which was created during the COVID-19 pandemic when in-home volunteers could no longer enter Veterans’ homes. The program targets Veterans who are lonely, socially isolated or seeking additional social connection. Volunteers and Veterans are matched based on common interests. Trained volunteers provide support by making periodic phone calls. Program referrals are made from VA providers in several clinical programs (e.g. Home-based Primary Care). To date, CCC has been implemented in more than 80 sites in the VA, with 310 volunteers, 5,320 visits, and 4,757 hours spend with Veterans.