Higher Levels Of Social Isolation Research Articles

Bidirectional and Dynamic Relationships Between Social Isolation and Loneliness Among Older Adults in China

ObjectivesThis study aimed to investigate the bidirectional associations and temporal dynamics between social isolation (SI) and loneliness among older adults. DesignThis is a prospective cohort study. Setting and ParticipantsWith the global phenomenon of population aging, there has been a significant increase in the prevalence of SI and loneliness among older adults. These factors exert substantial impacts on the health and well-being of this population. Consequently, it is imperative to implement more effective interventions targeting SI and combating loneliness in order to enhance the overall health and well-being of older adults. MethodsData from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed, focusing on individuals aged 65 and older. Generalized Cross-Lagged Modeling (GCLM) was used to assess these associations. ResultsThe findings reveal significant cross-lagged effects between SI and loneliness over the course of 16 years. Higher levels of SI at 1 time point predict increased loneliness scores in subsequent periods, and greater levels of loneliness at 1 time point predict higher SI scores in future periods. Notably, the impact of SI on loneliness is found to be larger and more enduring compared to the influence of loneliness on SI. These cross-lagged effects persist over an extended period, indicating a long-term reciprocal relationship between SI and loneliness among older adults. Conclusions and ImplicationsThis study provides valuable insights into the bidirectional associations between SI and loneliness among older adults. Given that the effect of SI dominates, the findings suggest that public health strategies aimed at promoting health and well-being should prioritize interventions that enrich older adults’ social networks. Emphasizing early interventions aimed at enhancing social networks is essential for promoting healthy aging and overall well-being.

Loneliness, social isolation, and cardiovascular disease among nonveteran and veteran women

We examined the prospective associations of social isolation and loneliness with incident cardiovascular disease (CVD) among aging nonveteran and veteran women, and effect modification by veteran status. Participants with no history of myocardial infarction (MI), stroke, coronary heart disease (CHD), or coronary heart failure from the Women’s Health Initiative Extension Study II self-reported social isolation, loneliness, health behaviors, health status, and veteran status. CVD and CVD subevents were physician adjudicated. Hazard ratios (HR) and 95% confidence intervals (CI) for the Interquartile Range (IQR) in social isolation (IQR = 1) and loneliness (IQR=.33) were calculated using Cox proportional hazard models adjusting for sociodemographic, health behavior, and health status characteristics. Veteran status was tested as an effect modifier. Among 52,442 women (Mean age = 79 ± 6.1; veterans n = 1023; 89.2% non-Hispanic White), 3579 major CVD events occurred over an average 5.8 follow-up years. Compared to nonveterans, veteran women reported higher levels of social isolation (p < .01) and loneliness (p < .01). The CVD HR was 1.07 (95% CI, 1.04–1.10) for the IQR in social isolation and 1.03 (95% CI, 1.10–1.06) for the IQR in loneliness. The HR for the IQR in both social isolation and loneliness was 1.10 (95% CI, 1.05–1.15). Social isolation was associated with CHD (HR = 1.12; 95% CI, 1.03–1.21). The CHD HR for the IQR in social isolation was 1.12 (95% CI, 1.03–1.21). Associations did not differ by veteran status (all p-interactions > 0.08). Findings suggest that the adverse associations of social isolation and loneliness with CVD are similar among veteran and nonveteran women.

Impact of subjective well-being on physical frailty in middle-aged and elderly Japanese with high social isolation.

Social isolation exacerbates physical frailty and is associated with subjective well-being. Even those with high levels of social isolation may have different health statuses depending on the type of isolation and their subjective well-being. However, the effect of subjective well-being on the relationship between social isolation and physical frailty remains unclear. This study examined whether the risk of physical frailty was the same for individuals with social isolation according to high and low subjective well-being. The study participants included 1,953 middle-aged Japanese adults aged 45 years and older. Physical frailty was assessed using a modified version of the Fried phenotype criteria. Probabilistic Latent Semantic Analysis was used to classify participants according to social isolation indicators. Subsequently, we focused on the groups with high social isolation and classified them according to whether their subjective well-being was high or low. Subjective well-being was evaluated using the Shiawase and Ikigai scales, which are concepts used in Japan. Finally, we used survival time analysis to examine the relationship between Shiawase or Ikigai and physical frailty in groups with high social isolation. The participants were classified into four groups based on their social isolation status. The physical frailty rate of the high social isolation class was 37.0%, which was significantly higher than that of the other classes. Survival time analysis revealed that among people with high social isolation, those with high Shiawase and Ikigai had a significantly lower risk of physical frailty than those with low Shiawase and Ikigai. All individuals with high social isolation are not at a high risk of physical frailty. The findings reveal that even those with high level of social isolation may have a lower risk of physical frailty if their subjective well-being is high. These results will contribute to promoting the prevention of frailty in middle-aged and older adults.

Abstract TP14: SocialBit: A Novel Smartwatch Sensor to Detect Social Interaction Frequency in Stroke Survivors

Introduction: Stroke survivors experience high levels of social isolation which hinder their rehabilitation and well-being. A gap in the field that impedes intervention development is a lack of real-time social interaction measurement tailored for this population. In response, we developed SocialBit, a smartwatch-based machine learning algorithm to discreetly and passively detect social interactions through privacy-preserving acoustic analysis. In this observational study, we estimated the accuracy of SocialBit to detect social interactions compared to human observers in stroke survivors. Methods: SocialBit was built as a neural network machine learning algorithm using features from YAMNet and a Transformer classifier. It was then trained and tested in stroke survivors for up to 8 days in hospital. Independently, human observers tallied the presence or absence of social interactions every minute to establish the ground truth. SocialBit performance of detecting social interactions was compared against the ground truth. Results: We analyzed 1137.7 hours of ambient audio data in 90 patients within 14 days of stroke onset. 16% of patients had aphasia, 25% reported symptoms of clinical depression, and 28% reported moderate to severe loneliness. SocialBit had an accuracy of 0.83 (SD = 0.2), sensitivity of 0.86 (SD = 0.2), specificity of 0.81 (SD = 0.02), and an area under the curve (AUC) of 0.90 (SD = 0.2) (Figure 1). Conclusion: SocialBit accurately detected the frequency of social interactions in stroke survivors in a hospital setting. These results will drive future planned studies to examine SocialBit's performance in patients’ home communities. SocialBit shows the potential to be the first real-time social sensor to quantify social interactions and social isolation in stroke survivors.

Bidirectional and dynamic relationships between social isolation and activities of daily living among older adults in China.

Social isolation and disability in performing activities of daily living are increasingly recognised as significant public health concerns globally. We aimed to investigate their bidirectional associations and the related temporal dynamics in Chinese older adults. We retrieved data from the six waves of the Chinese Longitudinal Healthy Longevity Survey (2002-18) and used generalised cross-lagged modelling (GCLM) to assess the bidirectional associations between social isolation and disability in performing activities of daily living. We found that higher levels of social isolation were predictive of increased scores in disabilities in performing activities of daily living. Conversely, disabilities in performing activities of daily living showed less predictive power in relation to social isolation. The temporal dynamics analysis indicated a peak in the bidirectional associations after approximately six years, followed by decreasing trends. Our results indicate that social isolation is dominant in the bidirectional relationship. Efforts focusing on reducing it can potentially minimise disabilities in performing activities of daily living among older adults. Reinstating preventive interventions beyond the six-year mark could help maintain their effectiveness.

Improvement of Social Isolation and Loneliness and Excess Mortality Risk in People With Obesity

Individuals with obesity experience markedly higher levels of social isolation and loneliness than those without obesity, but little is known about whether improvement of social isolation or loneliness might attenuate obesity-related excess risk of mortality. To investigate whether improvement of social isolation or loneliness is associated with lower obesity-related excess risk of mortality. This cohort study included individuals without cancer or cardiovascular disease (CVD) at baseline from the UK Biobank with follow-up beginning in March 2006 and ending in November 2021. All-cause, cancer-related, and CVD-related mortality were estimated. A total of 398 972 participants were included in this study (mean [SD] age, 55.85 [8.08] years; 220 469 [55.26%] women; 13 734 [3.44%] Asian, 14 179 [3.55%] multiracial, and 363 685 [91.16%] White participants). Overall, 93 357 (23.40%) had obesity, and 305 615 (76.60%) did not. During a median (IQR) follow-up of 12.73 (12.01-13.43) years, a total of 22 872 incident deaths were recorded. Compared with participants with obesity with an index of 2 or greater for social isolation, the multivariable adjusted hazard ratios (HRs) for all-cause mortality were 0.85 (95% CI, 0.79-0.91) and 0.74 (95% CI, 0.69-0.80) for participants with obesity and a social isolation index of 1 and 0, respectively (P for trend < .001); compared with participants with obesity and an index of 2 for loneliness, the HRs and 0.97 (95% CI, 0.89-1.06) and 0.86 (95% CI, 0.79-0.94) for participants with obesity and a loneliness index of 1 and 0, respectively (P for trend < .001). As the index of social isolation and loneliness went from highest to lowest, the HR for all-cause mortality decreased by 36% and 9%, respectively, in people with obesity compared with people without obesity using the multivariable model. Social isolation was ranked higher than loneliness, depression, anxiety, and lifestyle-related risk factors including alcohol, physical activity, and healthy diet for estimating the risks of all-cause mortality, cancer-related mortality, and CVD-related mortality. In this cohort study of UK Biobank participants, a lower index of social isolation or loneliness was associated with a decreased risk of all-cause mortality among people with obesity, and improvement of social isolation and loneliness attenuated obesity-related excess risk of all-cause mortality.

Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey

BackgroundSocial isolation and loneliness have been proved to be associated with many adverse health outcomes, but their influence on hypertension remains unclear. This study aimed to assess the relationship of social isolation and loneliness with hypertension risk among middle-aged and older adults in China. MethodsWe used data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were assessed for social isolation and loneliness at baseline, and hypertension was identified by self-report and blood pressure measurement at follow-up in 2015. Binary logistic regression analyses were conducted to assess the association of social isolation and loneliness with the risk of hypertension. ResultsA total of 3711 residents were included. 13.7 % of the participants had high level of social isolation and 18.1 % felt lonely. During the four-year follow up period, 651 participants developed hypertension. People with high level of social isolation had an increased risk of hypertension (odds ratio [OR]: 1.40, 95 % confidence interval [CI]: 1.09–1.79). Similar results were found between social isolation score and hypertension risk (OR: 1.14, 95 % CI: 1.04–1.26). No significant association between loneliness and hypertension or any interaction effect of social isolation and loneliness on hypertension were observed. LimitationsLimited by the structure of questionnaire, some of the information was derived by self-report, which may lead to recalling bias. ConclusionSocial isolation, rather than loneliness was associated with hypertension for middle aged and older adults. Social support needs to be strengthened for hypertension prevention in community.

A prospective association between social isolation and cognitive performance among older adults in Europe: the role of loneliness and poor oral health

Objectives The relationship between social isolation, loneliness, and tooth loss and cognition in older people is poorly understood. We examine how social isolation and cognitive performance are associated prospectively among older adults, as well as how tooth loss and loneliness are related to this association. Methods Using data from 26,168 participants aged ≥50 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we explored the association between social isolation, loneliness, tooth loss and cognition. We used bootstrapping with resampling strategies for testing a moderated mediating model. Results Higher social isolation was associated with poorer cognitive performance (B = −0.20, 95% CI = −0.03, −0.01; R 2 =0.60), an association mediated by the respondent’s number of missing teeth (B = −0.001, 95% CI = −0.002, −0.001). Higher levels of social isolation were associated with a greater number of missing teeth, and a higher number of missing teeth was linked with poorer cognition. We also found that loneliness moderated the relationship between social isolation and both the number of missing teeth (B = −0.11, p = 0.047) and cognitive performance. Conclusion In later life, social isolation and loneliness are associated with shoddy oral health and poor cognitive status. Clinicians and policymakers should be aware of both the association between social isolation and feelings of loneliness on dentition and oral health and their relationship to the cognitive status of older adults.

Modelling the impact of social isolation on the rate of cognitive decline of dementia patients

AbstractBackgroundThe current study looked to model the impact of social isolation (SI), using marital status as a proxy, on the rate of cognitive decline of dementia patients. It was hypothesised that patients with higher levels of SI (whose marital statuses reflected less socially connected living conditions) would exhibit steeper rates of cognitive decline over time than patients with lower levels of SI, and patients with higher levels of SI would have lower intercept cognitive scores compared to patients with lower levels of SI.MethodPatient demographic, diagnosis, cognitive assessment (Mini‐Mental State Examination [MMSE]/Montreal Cognitive Assessment [MoCA]) and marital status data were collated from electronic health records. Linear mixed‐effects models were used to explore the main effects and interaction effects of SI on the rate of cognitive decline of 4,137 patients from date of diagnosis to up to five years after (17,131 total observations).ResultComparisons for the MMSE and MoCA models showed the main effect models significantly outperformed null models testing the fixed effect of only diagnosis duration. The models revealed a similar rate of cognitive decline across all marital statuses. Excluding divorced patients, average intercept scores for less isolated marital statuses (married, civil‐partnership cohabiting) were higher than more isolated marital statuses (single, separated, widowed) for the MMSE models, but not the MoCA models. Interestingly, divorced patients had the highest average intercept scores in both the MMSE and MoCA models.ConclusionFuture research should look to develop the SI proxy using data from the COVID‐19 pandemic to explore the implications of isolation through enforced social restrictions on cognitive decline in dementia patients.

Effects of Distance-Learning Strategies in Dental Fixed Prosthodontics Amidst the COVID-19 Pandemic: Cross-Sectional Questionnaire Study on Preclinical Dental Students' Perspective.

COVID-19's high transmissibility led to gathering restrictions where dental schools experienced disruptions due to restrictions on attending in-person lectures and limitations placed on applied preclinical and clinical activities. Students not only had to rapidly switch to digital technology-based learning (TB-learning) modules but also experienced high levels of social isolation and anxiety around virus transmission. This study aims to evaluate the preclinical students' perception of switching TB-learning modules amidst the COVID-19 pandemic, identifying which module parameters were associated with strong student outcomes. A web-based survey of 39 Likert scale questions was delivered to preclinical dental students (Western University) to evaluate students' perceptions concerning TB-learning, fear amidst the COVID-19 pandemic, and the impact on their preclinical training. A Spearman rank correlation coefficient was determined to estimate the relationship between 2 variables in isolation (P=.01). An ordinal regression analysis was performed on variables of interest to determine how module variables (typically within the instructor's control) influenced the student outcomes (P=.05). The response rate was 30% (n=39). TB-learning was considered vital (34/39, 87.2%) as the students' education improved (18/39, 46.2%). However, 53.8% (n=21) of students showed increased difficulties in retaining, visualizing, or understanding the materials using TB-learning, and 64.1% (n=25) found it more difficult to concentrate than in in-person classes. In total, 79.5% (n=31) of students showed different levels of agreement about feeling fatigued from TB-learning. Through Spearman ρ correlation analysis, the quality of questions in quizzes (ρ=0.514; P<.001), relevant handouts (ρ=0.729; P<.001), and high-quality audiovisuals (ρ=0.585; P<.001) were positively correlated with students responding that the modules were useful to preclinical training. Similarly, good organization (ρ=0.512; P<.001), high-quality questions in quizzes (ρ=0.431; P=.01), and relevant handouts (ρ=0.551; P<.001) were positively correlated with web-based classes as an effective way to learn. In total, 91.6% (n=36) of the students agreed that COVID-19 was a dangerous disease, whereas 53.8% (n=21) showed different levels of agreement that they were afraid to be infected personally, and 69.2% (n=27) feared passing COVID-19 along to family and friends. A total of 82.1% (n=32) of the students showed that COVID-19 impacted their overall learning process and had a negative impact on their practical preclinical training (31/39, 79.5%). The students found a difference between TB-learning and face-to-face learning methods, where the students perceived fatigue toward the web-based method with difficulty concentrating and visualizing the subject. Moreover, there was a consensus that COVID-19 itself affected the students' overall learning process and preclinical training. As dental schools continue implementing TB-learning into their curriculum, this investigation identifies the students' struggles with the paradigm shift. In an effort to improve TB-learning, this work highlights 4 variables (organization, quizzes, quality handouts, and quality audiovisuals) within the control of instructors that can help improve content deliverance, improving the students' experience.

Examining the Interrelationships Between Social Isolation and Loneliness and Their Correlates Among Older British Adults Before and During the COVID-19 Lockdown: Evidence From Four British Longitudinal Studies.

Unprecedented social restrictions during the coronavirus disease 2019 (COVID-19) pandemic have provided a new lens for considering the interrelationship between social isolation and loneliness in later life. We present these interrelationships before and during the COVID-19 restrictions and investigate to what extent demographic, socioeconomic, and health factors associated with such experiences differed during the pandemic. We used data from four British longitudinal population-based studies (1946 NSHD, 1958 NCDS, 1970 BCS, and ELSA, N = 12,129). Rates, co-occurrences, and correlates of social isolation and loneliness are presented prior to and during the early stage of the COVID-19 pandemic and the interrelationships between these experiences are elucidated in both periods. Across the Four studies, prepandemic proportions reporting social isolation ranged from 15% to 54%, with higher rates in older ages (e.g., 32% of individuals aged 70-79 years and 54% of those more than 80). During the pandemic, the percentage of older people reporting both social isolation and loneliness and isolation only slightly increased. The interrelationship between social isolation and loneliness did not change. Associations between sociodemographic and health characteristics and social isolation and loneliness also remained consistent, with greater burden among those with higher economic precarity (females, nonhomeowners, unemployed, illness, and greater financial stress). There were already large inequalities in experiences of social isolation and loneliness and the pandemic had a small impact on worsening extent and inequalities in these. The concepts of loneliness and social isolation are not interchangeable, and clarity is needed in how they are conceptualized, operationalized, and interpreted. Given many older adults experience high levels of social isolation, there should be greater emphasis on reducing social isolation and the inequalities observed in who experiences greater isolation and loneliness.

Childhood maltreatment and midlife cognitive functioning: A longitudinal study of the roles of social support and social isolation.

Negative consequences of childhood maltreatment have been well-documented, including poorer executive functioning and nonverbal reasoning in midlife. However, not all adults with a history of childhood maltreatment manifest these outcomes, suggesting the presence of risk and protective factors. Based on growing empirical support for the importance of social variables in understanding neuropsychological development and functioning, we examined whether social support and social isolation mediate or moderate the effects of childhood maltreatment on cognitive functioning in midlife. In the context of a prospective cohort design study, individuals with documented histories of childhood maltreatment (ages 0-11 years) and demographically matched controls were followed up and interviewed in adulthood. Social support and isolation were assessed in young adulthood (Mage = 29), and cognitive functioning was assessed in midlife (Mage = 41). Structural equation modeling was used for mediation and linear regressions for moderation. Childhood maltreatment predicted higher levels of social isolation and lower levels of social support and cognitive functioning. Only social isolation mediated the relationship between childhood maltreatment and midlife cognitive functioning, whereas childhood maltreatment interacted with social support to predict Matrix Reasoning in midlife. Social support was protective for the control group but not for those maltreated. Social isolation and social support play different roles in understanding how childhood maltreatment impacts midlife cognitive functioning. Greater social isolation predicts greater deficits in cognitive functioning overall, whereas the protective effects of social support are limited to those without a documented history of childhood maltreatment. Clinical implications are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Social isolation, coping efficacy, and social well-being over time in patients with lung cancer.

500 Background: Coping efficacy and social isolation are each uniquely related to social well-being among those with lung cancer, yet little is known how they fluctuate in the context of one’s CT scan. For the present study, researchers tested the cross-sectional relationship between social isolation and social well-being, as well as the longitudinal relationship between monthly coping efficacy and social well-being in the months before one’s CT scan. Methods: 25 patients with lung cancer who were within 6 months of their upcoming CT scan were recruited. These participants were predominantly white (80%; Black: 12%), women (96%), and were between 43 and 78 years old ( M = 62.33, SD = 8.10). Baseline surveys asked about demographic information and social isolation; the repeated monthly surveys asked about coping efficacy and social well-being every 30 days until one’s scan. Results: During months when participants reported high coping efficacy, they also reported increases in social well-being (γ10 = 0.07, t = 2.44, p = .02). In addition, if the participant reported high levels of social isolation at baseline, they reported low levels of social well-being (γ01 = -0.63, t = -3.01, p = .007). Our model accounted for 10.53% of the within-person variance, and 26.65% of the between-person variance, in monthly social well-being. Conclusions: This longitudinal study was the first to look at how social isolation and coping efficacy relate to social well-being in a cancer-specific context. That is, among those with lung cancer who are approaching their upcoming CT scans. Future research should identify specific mechanisms to intervene that could help patients with lung cancer improve their social well-being as they approach their recurrent scans.

Association of Social Isolation With Hospitalization and Nursing Home Entry Among Community-Dwelling Older Adults

Social isolation is associated with adverse health outcomes, yet its implications for hospitalization and nursing home entry are not well understood. To evaluate whether higher levels of social isolation are associated with overnight hospitalization, skilled nursing facility stays, and nursing home placement among a nationally representative sample of community-dwelling older adults after adjusting for key health and social characteristics, including loneliness and depressive symptoms. This observational cohort study included 7 waves of longitudinal panel data from the Health and Retirement Study, with community-dwelling adults aged 65 years or older interviewed between March 1, 2006, and June 30, 2018 (11 517 respondents; 21 294 person-years). Data were analyzed from May 25, 2022, to May 4, 2023. Social isolation was measured with a multidomain 6-item scale (range, 0-6, in which a higher score indicates greater isolation). Multivariate logistic regressions were performed on survey-weighted data to produce national estimates for the odds of self-reported hospitalization, skilled nursing facility stays, and nursing home placement over time. A total of 57% of this study's 11 517 participants were female, 43% were male, 8.4% were Black, 6.7% were Hispanic or Latino, 88.1% were White, 3.5% were other ("other" includes American Indian or Alaska Native, Asian or Pacific Islander, and other race, which has no further breakdown available because this variable was obtained directly from the Health and Retirement Study), and 58.2% were aged 65 to 74 years. Approximately 15% of community-dwelling older adults in the US experienced social isolation. Higher social isolation scores were significantly associated with increased odds of nursing home placement (odds ratio, 2.01; 95% CI, 1.21-3.32) and skilled nursing facility stays (odds ratio, 1.16; 95% CI, 1.06-1.28) during 2 years. With each point increase in an individual's social isolation score, the estimated probability of nursing home placement or a skilled nursing facility stay increased by 0.5 and 0.4 percentage points, respectively, during 2 years. Higher levels of social isolation were not associated with 2-year hospitalization rates. This cohort study found that social isolation was a significant risk factor for nursing home use among older adults. Efforts to deter or delay nursing home entry should seek to enhance social contact at home or in community settings. The design and assessment of interventions that optimize the social connections of older adults have the potential to improve their health trajectories and outcomes.

Association of social isolation and cognitive performance: a longitudinal study using a four-wave nationwide survey

BackgroundThis study aimed to examine the bidirectional relationship between social isolation and cognitive performance among Chinese middle-aged and older adults.MethodsWe used four waves of data from the China Health and Retirement Longitudinal Study. A latent growth model (LGM) was applied to examine the association between social isolation and cognitive performance across different characteristics.ResultsIn the analysis, we ultimately included 9,367 participants after excluding respondents with missing key variables. Social isolation and cognitive performance showed significant differences across time. After adjusting for the confounders, there was a significant association between higher social isolation and poor cognitive performance (β = −1.38, p < 0.001), and higher levels of social isolation resulted in a more pronounced decline in cognition over time (β = 0.17, p < 0.001). Additionally, the path coefficient between the initial level of cognition at baseline and the slope of social isolation was − 0.07 (p < 0.001) and 0.01 (p = 0.021), respectively. For the correlation between slopes, our study found that females’ cognition scores were more susceptible to social isolation (β = − 2.78, p < 0.001). Similarly, regarding cognition scores, the influence of social isolation was greater among people with education below the primary level (β = − 2.89, p = 0.002) or a greater number of chronic diseases (β = − 2.56, p = 0.001).ConclusionOur findings support the bidirectional association between social isolation and cognition. Specifically, higher baseline social isolation and its rate of increase over time contribute to an intensification of cognitive decline at follow-up. Besides, poorer cognitive performance predicted higher social isolation.

Perceived social support mediates loneliness and social isolation: A cross-sectional study of Chinese older adults relocated for poverty relief.

This study aimed to examine the mediating effect of perceived social support in the relationship between loneliness and social isolation among Chinese older adults relocated for poverty relief. We surveyed 128 older migrants from four resettlement areas in Guizhou Province, southwest China. A general information questionnaire, the Lubben Social Network Scale-6, the Perceived Social Support Rating Scale, and the Single Item Loneliness Scale were used in our study. We also used the SPSS macro PROCESS to test a mediation model and the Bootstrap method to assess its significance. The prevalence of social isolation among older relocators was 85.9%; the mediation model showed that loneliness had a direct negative effect on social isolation (B=-1.25, p<0.01), and that perceived social support fully mediated this effect (-1.18), with a total effect of -1.25 (p<0.01) and a mediating proportion of 94.4%. Older relocators in poverty alleviation areas experienced high levels of social isolation. Perceived social support might buffer the negative impact of loneliness on social isolation. We suggest that interventions should be designed to enhance perceived social support and reduce social isolation among this vulnerable population.

Impact of Social Isolation, Physician-Patient Communication, and Self-perception on the Mental Health of Patients With Cancer and Cancer Survivors: National Survey Analysis.

Cancer is perceived as a life-threatening, fear-inducing, and stigmatized disease. Most patients with cancer and cancer survivors commonly experience social isolation, negative self-perception, and psychological distress. The heavy toll that cancer takes on patients continues even after treatment. It is common for many patients with cancer to feel uncertain about their future. Some undergo anxiety, loneliness, and fear of getting cancer again. This study examined the impact of social isolation, self-perception, and physician-patient communication on the mental health of patients with cancer and cancer survivors. The study also explored the impact of social isolation and physician-patient communication on self-perception. This retrospective study used restricted data from the 2021 Health Information National Trends Survey (HINTS), which collected data from January 11, 2021, to August 20, 2021. We used the partial least squares structural equation modeling (PLS-SEM) method for data analysis. We checked for quadratic effects among all the paths connecting social isolation, poor physician-patient communication, mental health (measured using the 4-item Patient Health Questionnaire [PHQ-4]), and negative self-perception. The model was controlled for confounding factors such as respondents' annual income, education level, and age. Bias-corrected and accelerated (BCA) bootstrap methods were used to estimate nonparametric CIs. Statistical significance was tested at 95% CI (2-tailed). We also conducted a multigroup analysis in which we created 2 groups. Group A consisted of newly diagnosed patients with cancer who were undergoing cancer treatment during the survey or had received cancer treatment within the last 12 months (receipt of cancer treatment during the COVID-19 pandemic). Group B consisted of respondents who had received cancer treatment between 5 and 10 years previously (receipt of cancer treatment before the COVID-19 pandemic). The analysis indicated that social isolation had a quadratic effect on mental health, with higher levels of social isolation associated with worse mental health outcomes up to a certain point. Self-perception positively affected mental health, with higher self-perception associated with better mental health outcomes. In addition, physician-patient communication significantly indirectly affected mental health via self-perception. The findings of this study provide important insights into the factors that affect the mental health of patients with cancer. Our results suggest that social isolation, negative self-perception, and communication with care providers are significantly related to mental health in patients with cancer.

Exploring the trajectory and correlates of social isolation for veterans across a 6-month period during COVID-19.

Social isolation is a relevant problem for veterans who are at risk for disengaging from others as a function of transition stress from military life to civilian life, and given high rates of exposure to trauma and psychological distress. Few researchers have examined social isolation in veterans over time, particularly during COVID-19 that led to significant barriers and restrictions on social interactions. The purpose of this longitudinal study was to assess veterans' experience of social isolation and its mental health and social functioning correlates during a 6-month period of the COVID-19 pandemic. Participants were 188 United States veterans of the Iraq and Afghanistan wars. A total of four assessments were administered: one every two months for a total duration of six months. The average number of completed assessments across all participants was 3.70 (SD = 0.75) with 159 participants (84.13%) completing all four timepoints. Surveys included measures of global mental health and social functioning as indicated by perceived emotional support, quality of marriage, and couple satisfaction. Multilevel modeling was used to assess 1) growth models to determine whether social isolation changed over time and the trajectory of that change (i.e., linear or quadratic); and 2) whether social isolation was related to both concurrent and prospective indicators of mental health and social functioning. All analyses included person mean centered and grand mean centered isolation to assess for within-and between-person effects. Veterans reported a quadratic trajectory in social isolation that decreased slightly and stabilized over time. Findings indicate that higher social isolation, at both the within- and between-person level, was negatively associated with concurrent emotional support, mental health, quality of marriage, and couple satisfaction. However, all prospective effects were nonsignificant at the within-person level. Results suggest although isolation may decrease over time, veterans report worse mental health and social functioning during times when they report higher levels of social isolation compared to themselves and others. Future work is needed to determine if interventions can be applied during those times to prevent or target those negative associations.

Co-Occurring Autism Spectrum and Borderline Personality Disorder: An Emerging Clinical Challenge Seeking Informed Interventions.

Co-Occurring Autism Spectrum and Borderline Personality Disorder: An Emerging Clinical Challenge Seeking Informed Interventions.

Relationship Between Depression, Social Isolation, and Well-Being Among Older Adults

ABSTRACT&#x0D; Objective &#x0D; The objective of this research was to determine the relationship between mental health, marital status, social isolation and loneliness among a sample of older adults at an old age care facility. &#x0D; Method &#x0D; Older adults (N = 26) above the age of 70 completed a survey for conditions of depression, isolation, social well-being, physical health, and marital status.&#x0D; Results &#x0D; There was no significant association found between poorer well-being and depression, p=.863. Marital status in older adults did not make a difference on levels of depression, p=.791. There was a significant association between higher levels of social isolation and higher loneliness and well-being, ps &lt; .001.&#x0D; Discussion &#x0D; These findings suggest that even older adults who are socially isolated in a community home may experience poorer mental health and physical health outcomes.