Connectedness For Older Adults Research Articles

Stronger Together: A Qualitative Exploration of Social Connectedness in Parkinson's Disease in the Digital Era.

Social isolation is a common consequence of Parkinson's disease (PD), and social prescribing has become a crucial aspect for fostering well-being in this population. In fact, group work has been shown to improve levels of social connectedness in older adults across different domains. Increased technology use in older adults may also contribute to increased social connections, especially since the COVID-19 pandemic. Still, the impact of digital use on social connectedness remains to be further explored in individuals with PD. Therefore, the purpose of this study was to examine the perceptions of social connectedness in relation with group-based activities and use of digital technologies in this population. Ten individuals with PD participated in focus groups. Transcripts of the video-recorded groups were analyzed qualitatively using thematic analysis. The three constructed themes not only revealed changes and challenges in social connectedness but also underscored the power of family and new relationships established through PD. Results also highlighted the overall positive impact of current digital technologies, although the view on telehealth per se was multifaceted. Referrals for group rehabilitation programs can enhance social connectedness in individuals with PD through fostering new social connections and community building. Hence, group rehabilitation programs should be viewed as a form of social prescribing. The use of digital technologies should be further explored as a means to maximize social engagements in this population.

IMPLEMENTATION OF A COMMUNITY WALKING PROGRAM FOR OLDER ADULTS WITH MOBILITY CHALLENGES—WALK-ON!

Abstract Clinical trials in controlled settings show walking interventions improve function and reduce mobility loss in older adults. In the NIA-funded LIFE study, participants with more compromised function derived the most benefit, yet improvements were not sustained. Based on this research, clinicians often prescribe walking for older patients. However, few communities provide accessible opportunities for those with limited function to engage in safe, ability-appropriate, walking. Additionally, no evidence-based National Council on Aging exercise programs emphasize ambulation over longer distances in supervised and social settings. In collaboration with community partners, we developed and initiated Walk On!, a group-based, facilitator-led program designed to improve walking endurance, balance, confidence, and social connectedness in older adults with mobility challenges. In addition to walking, the program incorporates balance, gait, and flexibility components, and follows a safe progression based on individual ability. Sessions take place for one-hour, twice/week, over 12 weeks. The program is currently offered at four sites in Winston-Salem and Charlotte, NC (two churches-one primarily black membership and one primarily white, a YWCA, and a community fitness center). This symposium provides an overview of Walk On! and initial implementation. Both quantitative and qualitative program data on feasibility, satisfaction, and effectiveness for improving physical and psychosocial outcomes will be presented. Based on these early data, we believe there are countless underserved older adults who may be socially isolated due to limited mobility, yet are willing and would benefit from incorporating more ambulation in a safe and accessible environment.

Circumstances that promote social connectedness in older adults participating in intergenerational programmes with adolescents: a realist review

ObjectivesLimited social connectedness in older adults is a risk factor for poor physical and mental health. Older adults who are socially isolated, lonely and disconnected have a higher risk of...

Use and Acceptance of Digital Communication Technology by Older Adults for Social Connectedness During the COVID-19 Pandemic: Mixed Methods Study.

Older adults are at higher risk for health issues, including mental health problems. This was especially apparent during the COVID-19 pandemic, where older adults were simultaneously more vulnerable to the disease and the mental health concerns created by social distancing. Subsequently, the use of digital communication technology (DCT) became a critical option for maintaining social connectedness in older adults. Prior to the pandemic, the low uptake and use of technology by older adults was an established problem, known as the digital divide. However, not much is known about how this may have changed as a result of the pandemic. This study aims to explore how older adults maintained social connectedness through DCT during the pandemic and to understand factors influencing the use and acceptance of DCT. A mixed methods explorative field study was set up, involving surveys and interviews of 25 community-dwelling older adults (65-88 years old) living in the United Kingdom. The surveys included the internet acceptance questionnaire (based on the Technology Acceptance Model [TAM]); COVID-19 dysfunctional anxiety was captured using the COVID-19 Anxiety Scale (CAS). Background information (demographics, use of technology) was gathered before conducting semistructured interviews. We hypothesized that CAS would affect constructs of TAM and that predictive constructs of TAM would have remained valid during the pandemic. We also posited that there would be unidentified themes outside TAM that impacted the acceptance and use of DCT. We used the quantitative data to guide the semistructured interviews, which were then analyzed through thematic analysis to identify additional themes. Correlational analysis showed that CAS influences all constructs of TAM. We also saw that the predictive constructs of TAM, especially the perceived ease of use (PEU) and perceived usefulness (PU), remained valid during the pandemic. Common acceptance-influencing themes were encountered in both quantitative and qualitative analyses, with 3 matching the known constructs of TAM (PU, PEU, and behavioral intention). We identified 2 additional themes affecting acceptance, namely influence of the pandemic (situational context) and privacy and security concerns. DCT use (especially email and videoconferencing use) increased during the pandemic, but the results related to social networking sites were mixed. The COVID-19 pandemic impacted technology acceptance and use by older adults, encouraging their use of certain DCT apps (email and videoconferencing apps, such as WhatsApp). These apps helped insulate them from adverse effects (social isolation and loneliness). Other social networking apps, however, exerted a negative influence, increasing anxiety and a general feeling of negativity. Future studies should maximize older adult agency related to design, privacy, security, and user requirements for development. We also recommend that when studying DCT acceptance for older adults, our additional identified themes should be considered alongside the existing TAM constructs.

Effectiveness of Technology Interventions in Addressing Social Isolation, Connectedness, and Loneliness in Older Adults: Systematic Umbrella Review.

The global population of older adults (aged >60 years) is expected to triple to 2 billion by 2050. Proportionate rises in older adults affected by loneliness and social isolation (or social connectedness) are expected. Rapid deployability and social changes have increased the availability of technological devices, creating new opportunities for older adults. This study aimed to identify, synthesize, and critically appraise the effectiveness of technology interventions improving social connectedness in older adults by assessing the quality of reviews, common observations, and derivable themes. Following the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), 4 databases (PsycINFO, PubMed, Embase, and MEDLINE) were searched between February 2020 and March 2022. We identified reviews with adults aged ≥50 years in community and residential settings, reporting outcomes related to the impact of technologies on social disconnectedness with inclusion criteria based on the population, intervention, context, outcomes, and study schema-review-type articles (systematic, meta-analyses, integrative, and scoping)-and with digital interventions included. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to measure the strength of outcome recommendations including the risk of bias. The reviews covered 326 primary studies with 79,538 participants. Findings were extracted, synthesized, and organized according to emerging themes. Overall, 972 publications met the initial search criteria, and 24 met our inclusion criteria. Revised Assessment of Multiple Systematic Reviews was used to assess the quality of the analysis. Eligible reviews (3/24, 12%) were excluded because of their low Revised Assessment of Multiple Systematic Reviews scores (<22). The included reviews were dedicated to information and communications technology (ICT; 11/24, 46%), videoconferencing (4/24, 17%), computer or internet training (3/24, 12%), telecare (2/24, 8%), social networking sites (2/24, 8%), and robotics (2/27, 8%). Although technology was found to improve social connectedness, its effectiveness depended on study design and is improved by shorter durations, longer training times, and the facilitation of existing relationships. ICT and videoconferencing showed the best results, followed by computer training. Social networking sites achieved mixed results. Robotics and augmented reality showed promising results but lacked sufficient data for informed conclusions. The overall quality of the studies based on GRADE was medium low to very low. Technology interventions can improve social connectedness in older adults. The specific effectiveness rates favor ICT and videoconferencing, but with limited evidence, as indicated by low GRADE ratings. Future intervention and study design guidelines should carefully assess the methodological quality of studies and the overall certainty of specific outcome measures. The lack of randomized controlled trials in underlying primary studies (<28%) and suboptimal methodologies limited our findings. Robotics and augmented or virtual reality warrant further research. Low GRADE scores highlight the need for high-quality research in these areas. PROSPERO CRD42022363475; https://tinyurl.com/mdd6zds.

Weak Social Networks in Late Life Predict Incident Alzheimer's Disease: The Kuakini Honolulu-Asia Aging Study.

We assessed 10-year longitudinal associations between late-life social networks and incidence of all-cause dementia (ACD), Alzheimer's disease (AD), and vascular dementia (VaD) in Japanese-American men. We prospectively analyzed, from baseline (1991-1993) through 1999-2000, 2636 initially nondemented Kuakini Honolulu-Asia Aging Study participants who remained dementia-free during the first 3 years of follow-up. Global cognition was evaluated by the Cognitive Abilities Screening Instrument (CASI); depressive symptoms by the 11-item Center for Epidemiologic Studies Depression (CES-D) Scale; and social networks by the Lubben Social Network Scale (LSNS). Median split of LSNS scores defined weak/strong social network groups. A panel of neurologists and geriatricians diagnosed and classified dementia; AD and VaD diagnoses comprised cases in which AD or VaD, respectively, were considered the primary cause of dementia. Median (range) baseline age was 77 (71-93) years. Participants with weak (LSNS score ≤29) versus strong (>29) social networks had higher age-adjusted incidence (in person-years) of ACD (12.6 vs. 8.7; p = .014) and AD (6.7 vs. 4.0; p = .007) but not VaD (2.4 vs. 1.4; p = .15). Kaplan-Meier curves showed a lower likelihood of survival free of ACD (log-rank p < .0001) and AD (p = .0006) for men with weak networks. In Cox proportional hazards models adjusting for age, education, APOE ɛ4, prevalent stroke, depressive symptoms, and CASI score (all at baseline), weak networks predicted increased incidence of ACD (hazard ratio [HR] = 1.52, p = .009) and AD (HR = 1.67, p = .014) but not VaD (p > .2). Weak social networks may heighten the risk of dementia and AD, underscoring the need to promote social connectedness in older adults.

Technologies and the Effects On Social Engagement In Long-Term Care Facilities During COVID-19: A Scoping Review

During the COVID-19 pandemic, the sense of loneliness and social isolation felt by older adults in long-term care facilities has been exacerbated. Although there has been an increase in the number of digital solutions to mitigate social isolation during COVID-19, facilities in northern British Columbia do not have sufficient information regarding the technologies to support social connectedness. To support evidence-based policy decisions, a scoping review was conducted to identify existing virtual technology solutions, apps, and platforms that promote social connectedness among older adults residing in long-term care. A combination of keywords and subject headings were used to identify relevant literature within PubMed, CINAHL EBSCO, PsychINFO EBSCO, Embase OVIDSP, and Web of Science ISI databases. DistillerSR was used to screen and summarize the article selection process. Twenty-three articles were identified for full-text analysis. A variety of technologies are described which can be used to mitigate the impacts of social isolation felt by long-term care residents. However, many of these digital solutions require stable highspeed internet. This remains a challenge for facilities in northern areas as many have limited access to reliable internet. Metrics used to evaluate social engagement in the context of long-term care are also outlined. This research provides the preliminary groundwork necessary to better inform policy decisions about which technologies are available and, of these, which are effective at enhancing social connectedness for older adults in long-term care.

Social Connection Planning for Lonely or Socially Isolated Older Adults

Social connections are important for maintaining health and well-being with age. Behavioral interventions to promote connectedness hold promise, but there is limited evidence to guide effective modifications in the context of physical distancing or quarantine restrictions, such as those required during the COVID-19 pandemic. We present evidence for a brief (1-2 session) social connection intervention, “Connections Planning,” to enhance social connectedness for older adults. We first describe a cognitive-behavioral model of loneliness, which served as the framework for developing the intervention. We then present two case examples to demonstrate the application of the intervention with older adults in a community mental health clinic during physical distancing restrictions. Finally, we present initial findings from a pilot study to examine the feasibility and acceptability of the intervention delivered remotely with up to 10 community-dwelling older adults who endorse clinically significant loneliness. Recommendations for adapting the intervention during physical distancing restrictions are provided.

Implementation of a co-designed physical activity program for older adults: positive impact when delivered at scale

BackgroundDespite known health benefits of physical activity (PA), older adults remain among the least physically active age group globally with 30–60% not meeting guidelines. In Canada, 87% do not meet recommended guidelines. To influence population health, interventions that are effective in small trials must be disseminated at scale. Despite evidence for efficacy, few PA interventions are scaled up to reach the wider community. In 2015, British Columbia (BC) Ministry of Health released a PA strategy where older adults were identified as a priority. In partnership with the Ministry, the Active Aging Research Team co-created a health promotion program called Choose to Move (CTM). CTM will be implemented in three phases at increasingly greater scale across BC. The objective of this study is to evaluate the effectiveness of CTM during Phase I (pilot) and Phase II (initial scale up) on PA, mobility, and social connectedness among older adults in BC, Canada.MethodsWe used a type 2 hybrid effectiveness-implementation study design, and herein focus on effectiveness. The implementation evaluation will be published as a companion paper elsewhere. Two community delivery partner organizations delivered 56 CTM programs in 26 large and small urban locations across BC. Outcome measurement occurred at 0 (baseline), 3 (mid-intervention) and 6 (post-intervention) months. We collected survey data from all participants (n = 458; province-wide) and also conducted a subset evaluation (n = 209).ResultsPA increased significantly during the active intervention phase (baseline-3 months) in younger (60–74 yrs.; + 1.6 days/week; p < 0.001) and older (≥75 yrs.; + 1.0 days/week; p < 0.001) participants. The increase was sustained at 6 months in younger participants only, who remained significantly more active than at baseline (+ 1.4 days/week; p < 0.001). Social exclusion indicators declined significantly in the younger group. Mobility and strength improved significantly at 3 months in the younger group, and in both groups at 6 months.ConclusionsCTM adopted central tenets of implementation science that consider the complicated systems where interventions are delivered to improve public health. In this iteration of CTM we demonstrate that a partner-based health promotion intervention can be effectively implemented across settings to enhance PA, mobility and social connectedness in older adults.

Potential of telepresence robots to enhance social connectedness in older adults with dementia: an integrative review of feasibility.

Socially assistive robots are increasingly used as a therapeutic tool for people with dementia, as a means to improve quality of life through social connection. This paper presents a mixed-method integrative review of telepresence robots used to improve social connection of people with dementia by enabling real-time communication with their carers. A systematic search of Medline, ProQuest, PubMed, Scopus, Web of Science, CINAHL, EMBASE, and the Cochrane library was conducted to gather available evidence on the use of telepresence robots, specifically videoconferencing, to improve social connectedness, in people with dementia. A narrative synthesis was used to analyze the included studies. A review of 1,035 records, identified four eligible peer-reviewed publications, reporting findings about three different mobile telepresence robots. The study designs included qualitative and mixed-methods approaches, focusing primarily on examining the feasibility and acceptability of the telepresence robots within the context of dementia care. These studies reported both positive outcomes of using telepresence robots to connect people with dementia to others, as well as barriers, such as a lack of experience in using a robot and technological issues. Although limited, the current literature suggests that telepresence robots have potential utility for improving social connectedness of people with dementia and their carers. However, more systematic feasibility studies are needed to inform the development of telepresence robots followed by clinical trials to establish efficacy within dementia care.

UNDERSTANDING PERSON-PLACE TRANSACTIONS IN NEIGHBOURHOODS: A QUALITATIVE-GEOSPATIAL APPROACH

AbstractEmerging research regarding aging in context reveals much about neighbourhood characteristics that relate to aging adults’ health, participation and inclusion; however, in-depth information about the nature of person-place relationships is lacking. Shifting away from previous conceptualizations of place as static, a transactional perspective considers place as inseparable from the person, each shaping the other through complex, ongoing transactions. The inter-woven nature of person and place highlights the need to use methods that can examine this relationship in situ and explore meanings derived from places. Participatory geospatial methods (i.e. methods that involve the participant in collecting geospatial data) can capture situated details about place that are not verbalized during interviews or otherwise discerned, and qualitative methods can explore interpretations, both helping to generate deep understandings of the relationships between person and place. This presentation argues for applying qualitative-participatory geospatial approaches to this area of study and describes an innovative methodology. A study exploring how neighbourhood and person transact to shape a sense of social connectedness in older adults provided the basis from which we developed a combined qualitative-participatory geospatial methodology. Methods included global positioning system (GPS) tracking followed by map-based interviews, narrative interviews, and go-along interviews, with attention to integrating spatial and other forms of data during analysis. Findings indicate the unique understandings that each method contributes, the strengths and limitations of integrating geospatial with qualitative data, and the potential for this methodology to generate knowledge about person-place transactions that can inform practice, policy and research to promote older adults’ well-being.

Toward Understanding Person-Place Transactions in Neighborhoods: A Qualitative-Participatory Geospatial Approach.

Emerging research regarding aging in neighborhoods emphasizes the importance of this context for well-being; however, in-depth information about the nature of person-place relationships is lacking. The interwoven and complex nature of person and place points to methods that can examine these relationships in situ and explore meanings attached to places. Participatory geospatial methods can capture situated details about place that are not verbalized during interviews or otherwise discerned, and qualitative methods can explore interpretations, both helping to generate deep understandings of the relationships between person and place. This article describes a combined qualitative-geospatial approach for studying of older adults in neighborhoods and investigates the qualitative-geospatial approach developed, including its utility and feasibility in exploring person-place transactions in neighborhoods. We developed and implemented a qualitative-geospatial approach to explore how neighborhood and person transact to shape sense of social connectedness in older adults. Methods included narrative interviews, go-along interviews, and global positioning system tracking with activity/travel diary completion followed by map-based interviews. We used a variety of data analysis methods with attention to fully utilizing diverse forms of data and integrating data during analysis. We reflected on and examined the utility and feasibility of the approach through a variety of methods. Findings indicate the unique understandings that each method contributes, the strengths of the overall approach, and the feasibility of implementing the approach. The developed approach has strong potential to generate knowledge about person-place transactions that can inform practice, planning, policy, and research to promote older adults' well-being.

Facebook as a source of social connectedness in older adults

This study examines for the first time whether —and subsequently the extent to which— social connectedness can be derived from Facebook in a population of older Facebook users. Participants (N = 280) were aged between 55 and 81 years (Mage = 61.28 years). Exploratory factor analysis (maximum likelihood with direct oblimin rotation) revealed that Facebook social connectedness emerged as a separate factor to offline social connectedness, with correlations between the factors indicating that they were distinct constructs. In addition, participants reported levels of Facebook-derived social connectedness similar to those seen in younger samples in previous research. Future directions for research include identifying the mechanisms by which Facebook social connectedness might be associated with positive outcomes in older populations. Given the global rate of population ageing, these findings have important implications in terms of the delivery of social capital in older adults.

Connectedness in Community-Dwelling Older Adults

The purpose of this study was to examine the processes involved with connectedness in community-dwelling older adults, which the authors contend is quality of life from a generative perspective. Using a grounded theory approach, 12 older adults were interviewed using a semistructured interview guide. The tape-recorded interviews were transcribed verbatim, categories were created to code the data, and themes were extracted. Four processes involved with connectedness in older adults were identified: (a) having something to do, (b) having relationships, (c) having a stake in the future, and (d) having a sense of continuity. Various aspects of spirituality were also apparent in each of the four processes. This study suggests that connectedness provides older adults with a mechanism to engage life in meaningful, positive, and purposeful ways.