Chronic loneliness: neurocognitive mechanisms and interventions

Loneliness has been associated with detrimental effects on mental and physical health and is increasingly recognized as a critical public health issue which may be further exacerbated by societal challenges such as increasing urbanization, an aging society as well as the COVID-19 pandemic. We here review recent findings on the neurocognitive mechanisms and brain alterations that underpin social disconnectedness, therapeutic approaches for chronic loneliness and how these lines of research can be integrated to improve the efficacy of loneliness interventions in healthy individuals and patients with mental disorders.

An Integrative Framework to Guide Social Engagement Interventions and Technology Design for Persons With Mild Cognitive Impairment

Social isolation and loneliness in older adults are associated with poor health outcomes and have been linked to an increased risk of cognitive impairment and incident dementia. Social engagement has been identified as a key factor in promoting positive health behaviors and quality of life and preventing social isolation and loneliness. Studies involving cognitively healthy older adults have shown the protective effects of both in-person and technology-based social engagement. However, the benefits of social engagement for people who are already at-risk of developing dementia, namely those with mild cognitive impairment (MCI), have yet to be elucidated. We present a narrative review of the literature, summarizing the research on social engagement in MCI. First, we identified social networks (quality, size, frequency, and closeness) and social activities (frequency, format, purpose, type, and content) as two overarching dimensions of an integrative framework for social engagement derived from literature examining typical cognitive aging. We then used this framework as a lens to examine studies of social engagement in MCI to explore (i) the relationship between in-person and technology-based social engagement and cognitive, emotional, and physical health, and (ii) interventions that target social engagement including technology-based approaches. Overall, we found that persons with MCI (PwMCI) may have different levels of social engagement than those experiencing typical cognitive aging. Moreover, in-person social engagement can have a positive impact on cognitive, emotional, and physical health for PwMCI. With respect to activity and network dimensions in our framework, we found that cognitive health has been more widely examined in PwMCI relative to physical and emotional health. Very few intervention studies have targeted social engagement, but both in-person and technology-based interventions appear to have promising health and well-being outcomes. Our multidimensional framework of social engagement provides guidance for research on characterizing the protective benefits of social engagement for PwMCI and informs the development of novel interventions including technology-based approaches.

Anxiety Profile of PWD and Caregiver During COVID-19 Pandemic in ALZI Surabaya Community, Indonesia

The consequence of COVID-19 pandemic conditions in vulnerable groups such as Patients with Dementia (PWD) and their caregivers are required to be urgently addressed. This study was conducted to collect data on PWD and caregiver characteristics, also concluding the profile of anxiety during the COVID-19 pandemic in Alzi Surabaya Community. This research is an observational descriptive cross-sectional study using the Beck Anxiety Inventory and Rating Anxiety in Dementia questionnaire to apprehend the profile of anxiety in PWD and caregivers in the Alzi Surabaya Community during the COVID-19 pandemic. PWD in this community experience significant anxiety (82.35%) with symptoms such as sleep disturbance (100%) worry over trifles (92.85%), complaints of headache and body aches or pains (92.85%) also sweating, flushes or chills, tingling or numbness of extremities (42.85%) and insignificant anxiety (17.65%) with symptoms such as fatigue and tiredness (100%), worry about physical health (66.57%), irritability (66.57%), heart racing or thumping (33.33%). Caregivers of PWD in this community all experience low anxiety with symptoms such as fear of something worst happening (80%), unable to relax (65%), indigestion and dizziness or lightheadedness (55%). Intervention, in order to reduce anxiety in PWD and caregiver during and post-pandemic, is substantial as establishing a good quality of life is important for PWD to increase fulfilment in life and also important for caregivers in order to maintain quality of care.

How Do Housing Prices Affect Residents' Health? New Evidence From China

This paper aims to explore the effect and mechanism of rising housing prices on residents' physical and mental health. Using data from the China Family Panel Studies from 2014 to 2018, we investigate the impact and mechanism of rising housing prices on the mental and physical health of urban residents through multiple grouping regression and analysis of variance. The study finds that overall, rising housing prices have a positive effect on residents' mental health but a negative effect on physical health, and those who do not own a house show the greatest adverse effect. The impact of rising housing prices on health is mainly reflected in three aspects: the wealth effect, cost effect, and comprehensive environmental expectation effect. Of these, the wealth effect and comprehensive environmental expectation effect play a role in promoting residents' health, whereas the cost effect has a strong inhibitory effect. This paper also analyzes how house prices impact health and finds that having health insurance reduces residents' active health behavior, thus affecting their physical and mental health levels, which has a positive effect on uninsured residents.

The Importance of Emotional Regulation in Mental Health

Mental health is a critical component of overall well-being and exists on a continuum much like physical health. Although many ways to assess mental health exist outside of either having a disorder or not, practitioners often rely on the presence or absence of symptomatology. The assessment and promotion of emotional regulation in patients is one way to encourage individuals to engage in mental health-promoting behaviors. Specific techniques are discussed that address emotional regulation. Overall, providing patients with the tools to regulate emotional responding will likely have a direct impact on well-being as well as reduce MH symptomology.

COVID-19: Contrasting experiences of South African physiotherapists based on patient exposure

Background: The coronavirus disease 2019 (COVID-19) pandemic has exposed physiotherapists to unique work-related challenges. However, there is a lack of research regarding the mental health and lived experiences of South African physiotherapists during the COVID-19 pandemic.Objectives: To determine levels of mental and physical health, burnout, depression, anxiety and resilience and coping strategies used by a sample of South African physiotherapists with and without exposure to patients with COVID-19. Lived work experience, perceived health and sources of support were also explored.Method: A non-experimental, cross-sectional, mixed-method design was used. Physiotherapists completed an online survey comprising: a demographic questionnaire; scales assessing mental and physical health, burnout, depression, anxiety and coping strategies and six open-ended questions. A total of 171 physiotherapists participated in our study, 43.3% of whom were exposed to patients with COVID-19.Results: The exposure group scored significantly higher on self-reported mental health, anxiety, depression and burnout than the non-exposure group. No significant differences were reported for physical health and resilience. Significantly more maladaptive coping strategies were employed by the exposure group. Participants’ lived experiences highlighted similar experiences, as well as work-related challenges. Both groups reported that primary sources of support were significant others, but highlighted the lack of organisational support.Conclusion: Irrespective of the degree of exposure to COVID-19, the mental health and lived experiences of physiotherapists working in South Africa has been negatively impacted by COVID-19.Clinical implications: Understanding physiotherapists’ well-being and lived experiences during the pandemic may guide workplace interventions. Our findings suggest the need for psycho-educational intervention programmes to be implemented at an organisational level.