Objective: Although loneliness and social isolation are distinct constructs, only few studies have examined the putative synergistic effects of loneliness and social isolation on health. The current ...study strives to fill this gap. We ask, "Do loneliness, social isolation, and their interaction predict mortality?" Methods: We used a large nationally representative sample of middle-aged and older adults in Germany (N = 4,838) with a follow-up period of up to 20 years. Results: We found that the effects of loneliness and social isolation synergistically interact with each other: The higher the social isolation, the larger the effect of loneliness on mortality, and the higher the loneliness, the larger the effect of social isolation. Conclusions: Both constructs are important in predicting health. Researchers and practitioners should consider loneliness, social isolation, and their interaction whenever possible.
Objectives
To review the impact of social isolation during COVID-19 pandemic on mental and physical health of older people and the recommendations for patients, caregivers and health professionals.
...Design
Narrative review.
Setting
Non-institutionalized community-living people.
Participants
20.069 individuals from ten descriptive cross-sectional papers.
Measurements
Articles since 2019 to 2020 published on Pubmed, Scielo and Google Scholar databases with the following MeSh terms (‘COVID-19’, ‘coronavirus’, ‘aging’, ‘older people’, ‘elderly’, ‘social isolation’ and ‘quarantine’) in English, Spanish or Portuguese were included. The studies not including people over 60 were excluded. Guidelines, recommendations, and update documents from different international organizations related to mental and physical activity were also analysed.
Results
41 documents have been included in this narrative review, involving a total of 20.069 individuals (58% women), from Asia, Europe and America. 31 articles included recommendations and 10 addressed the impact of social distancing on mental or physical health. The main outcomes reported were anxiety, depression, poor sleep quality and physical inactivity during the isolation period. Cognitive strategies and increasing physical activity levels using apps, online videos, telehealth, are the main international recommendations.
Conclusion
Mental and physical health in older people are negatively affected during the social distancing for COVID-19. Therefore, a multicomponent program with exercise and psychological strategies are highly recommended for this population during the confinement. Future investigations are necessary in this field.
Perceived social isolation during the COVID-19 pandemic significantly has had an extraordinary global impact, with significant psychological consequences. Changes in our daily lives, feeling of ...loneliness, job losses, financial difficulty, and grief over the death of loved ones have the potential to affect the mental health of many. In an atmosphere of uncertainty, it is essential that clear and precise information is offered about the problem and how to manage it. In this contribution, a rationale is provided for an urgent call for a rapid response to the mental health impacts of COVID-19. Moreover, suggestions for individuals to regulate their emotions effectively and appropriately are provided.
Objective: The present analysis aimed to examine the associations of isolation and loneliness, individually as well as simultaneously, with 2 measures of functional status (gait speed and ...difficulties in activities of daily living) in older adults over a 6-year period using data from the English Longitudinal Study of Ageing, and to assess if these associations differ by SES. Method: Loneliness was measured using the short form of the Revised UCLA scale, and an index of social isolation was computed incorporating marital status; frequency of contact with friends, family, and children; and participation in social activities. Measures of functional status were assessed identically at baseline and 6 years later for 3070 participants (mean age 69 years). Wealth was used as an indicator of SES. Results: In fully and mutually adjusted models, social isolation and loneliness were found to be associated with a decrease in gait speed at follow-up, with stronger effects among more disadvantaged individuals. Loneliness was associated with an increase in difficulties with activities of daily living. Conclusions: Isolation and loneliness were adversely associated with different aspects of functional status. Interventions to reduce isolation and loneliness may be particularly beneficial for individuals in disadvantaged groups.
Increasing evidence suggests that perceived social isolation or loneliness is a major risk factor for physical and mental illness in later life. This review assesses the status of research on ...loneliness and health in older adults. Key concepts and definitions of loneliness are identified, and the prevalence, correlates, and health effects of loneliness in older individuals are reviewed. Theoretical mechanisms that underlie the association between loneliness and health are also described, and illustrative studies examining these mechanisms are summarized. Intervention approaches to reduce loneliness in old age are highlighted, and priority recommendations for future research are presented.
Older age and medical comorbidity are factors associated with more severe illness and risk of death due to COVID-19 infection. Social distancing is an important public health strategy for controlling ...the spread of the virus and minimizing its impact on the older adult population. It comes at a cost, however. Loneliness is associated with myriad adverse health outcomes, one of which is impaired immune functioning, which adds even greater risk for coronavirus infection, complications and death. Older adults, therefore, are at compound risk, making effective management of loneliness and social isolation in our older patients a high priority target for preventive intervention. In this paper, the authors describe a cognitive-behavioral framework for social connectedness, including evidence-informed strategies clinicians can use to help patients develop a "Connections Plan" to stay connected and promote their social, mental, and physical health during "social distancing" restrictions. This set of strategies can be provided during brief (30 minute) telephone sessions and is analogous to creating a "Safety Plan" for suicide risk. The approach is illustrated with three case examples.
Social isolation and loneliness have been associated with ill health and are common in the developed world. A clear understanding of their implications for morbidity and mortality is needed to gauge ...the extent of the associated public health challenge and the potential benefit of intervention.
A systematic review of systematic reviews (systematic overview) was undertaken to determine the wider consequences of social isolation and loneliness, identify any differences between the two, determine differences from findings of non-systematic reviews and to clarify the direction of causality.
Eight databases were searched from 1950 to 2016 for English language reviews covering social isolation and loneliness but not solely social support. Suitability for inclusion was determined by two or more reviewers, the methodological quality of included systematic reviews assessed using the a measurement tool to assess systematic reviews (AMSTAR) checklist and the quality of evidence within these reviews using the grading of recommendations, assessment, development and evaluations (GRADE) approach. Non-systematic reviews were sought for a comparison of findings but not included in the primary narrative synthesis.
Forty systematic reviews of mainly observational studies were identified, largely from the developed world. Meta-analyses have identified a significant association between social isolation and loneliness with increased all-cause mortality and social isolation with cardiovascular disease. Narrative systematic reviews suggest associations with poorer mental health outcomes, with less strong evidence for behavioural and other physical health outcomes. No reviews were identified for wider socio-economic or developmental outcomes.
This systematic overview highlights that there is consistent evidence linking social isolation and loneliness to worse cardiovascular and mental health outcomes. The role of social isolation and loneliness in other conditions and their socio-economic consequences is less clear. More research is needed on associations with cancer, health behaviours, and the impact across the life course and wider socio-economic consequences. Policy makers and health and local government commissioners should consider social isolation and loneliness as important upstream factors impacting on morbidity and mortality due to their effects on cardiovascular and mental health. Prevention strategies should therefore be developed across the public and voluntary sectors, using an asset-based approach.
•There is consistent evidence linking social isolation and loneliness to worse cardiovascular and mental health outcomes.•Less is known on the role of other conditions and wider socio-economic consequences.•Policy makers and commissioners should consider asset-based prevention strategies.
•A high prevalence of social isolation globally and the status of social isolation may change over time.•Intermittent and persistent isolation were associated with higher risks of mortality over the ...10-years follow-up.•Participants with persistent face-to-face isolation from co-inhabitants (including live alone) had higher risks of mortality.•Health policies addressing cognitive performance, depressive symptoms and health behaviours may reduce excess mortality among isolated people.
Although social isolation has been associated with higher mortality risk, the associations of persistence of social isolation with mortality are unclear. We investigated the prospective associations of intermittent and persistent social isolation with all-cause and cause-specific mortality, considering the social contact types (face-to-face and non-face-to-face). 30,518 participants were recruited in 2003–2008 initially and 18,104 participants with re-assessed social isolation information in 2008–2012 were followed up to Dec 2019 in Guangzhou Biobank Cohort Study (GBCS). During an average of 9.7 years of follow-up, 2,119 deaths occurred. The isolation at baseline survey, isolation at second survey and persistent isolation were positively associated with all-cause mortality in the minimal adjusted model (adjusted hazard ratio (AHR) =1.24, 95% CI 1.12–1.38, 1.11, 1.00–1.23 and 1.23, 1.05–1.43, respectively). Totally 47.2% of the risk was explained by health status, SEP, and biological, behavioural and psychological factors. Persistent isolation from face-to-face with co-inhabitants, versus no isolation, was associated with higher risks of all-cause (HR=1.40, 1.09–1.81) and CVD (subdistribution hazard ratio (SHR)=1.92, 1.31–2.81) mortality in fully adjusted model. Our study showed that intermittent and persistent isolation were generally associated with higher risks of mortality, and the risks were even higher in those with persistent face-to-face isolation with co-inhabitants.
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Preventing social isolation in older people Cotterell, Natalie; Buffel, Tine; Phillipson, Christopher
Maturitas,
July 2018, 2018-Jul, 2018-07-00, 20180701, Letnik:
113
Journal Article
Recenzirano
Odprti dostop
•Prolonged social isolation has harmful economic, health, and social consequences.•Scientific evidence regarding the prevention of isolation in later life is limited.•A life-course perspective helps ...identify and prevent isolation at key life stages.•Research must consider the implications of greater diversity in older populations.•A cultural change from ‘cure’ to ‘prevention’ of social isolation is required.
The extent of social isolation amongst older people has emerged as a major concern for health and social policy. Although the social and health outcomes of social isolation are well documented, evidence regarding the prevention of isolation in later life remains scarce. This article addresses this by presenting the findings from a literature review focusing on the identification, assessment, prevention, and intervention strategies relevant to social isolation in older age. The paper first addresses the issues of identification and assessment, using an ecological framework to identify the risk factors for social isolation at four levels: individual, relationship, community, and societal. It then reviews different types of interventions to reduce or prevent social isolation in later life, including one-to-one, group, service provision, technology-based, neighbourhood, and structural interventions. The paper discusses both the opportunities and the constraints associated with these different approaches. The discussion highlights future directions for research, emphasising the need for a cultural change from ‘cure’ to ‘prevention’ of social isolation across the life-course, and the importance of acknowledging greater diversity within the ageing population.
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