Social Isolation In Older Adults Research Articles

Comparison of the Effects of Mobile Learning and Traditional Self-care Education on Loneliness and Social Isolation in Community-dwelling Older Adults: Study Protocol of a Three-Arm Randomized Controlled Trial

Introduction: Loneliness and social isolation are common problems in older adults, which has negative effects on health. Increasing self-care ability seems to help. Therefore, the present study will be conducted with the aim of comparing the effects of mobile learning and traditional self-care education on loneliness and social isolation in community-dwelling older adults. Methods: This three-arm randomized controlled trial will be conducted in Tehran-Iran 2024. The qualified older adults from health centers in Tehran city will be consecutively selected and randomly allocated into three groups: mobile learning (n = 40), traditional education (n = 40), and control (n = 40). The loneliness inventory for older adults, Lubben social network scale, and demographic characteristics will be used to collect information, and completed before, immediately, and 12 weeks after the intervention. The data will be analyzed using descriptive and inferential statistics by SPSS software version 16 at a significance level of p < 0.05. Conclusion: This clinical trial will determine the most successful and cost-effective approach in reducing loneliness and social isolation in older adults. The results are expected to improve the self-care skills of the older adults, thereby reducing the negative consequences of loneliness and social isolation, including various health issues and mortality rates, in the long run.

Addressing loneliness and social isolation through the involvement of primary and secondary informal caregivers in nursing homes: a scoping review

ObjectivesTo clarify the mechanisms of interventions addressing loneliness and social isolation in older adults living in nursing homes through the involvement of primary and secondary informal caregivers.MethodsThis scoping review was performed by two independent reviewers, covering the period between 2011 and 2022 and the databases MEDLINE, CINAHL, PsycINFO and Scopus. It included terms related to (A) informal caregivers, (B) nursing homes, (C) psychosocial interventions, (D) involvement and (E) social isolation or loneliness.ResultsThirty-three studies met the inclusion criteria. Although there were various definitions and assessment tools related to social isolation and loneliness, the studies referred to three dimensions of these concepts in nursing home residents: the quantity of social interactions, the perception of these encounters and biographical changes in social relationships. Most studies did not explicate the mechanisms of these interventions. The review uncovered the following aspects of intervention mechanisms: increasing opportunities for social contact, creating meaningful encounters, maintaining existing relationships with primary informal caregivers and establishing new ones with secondary informal caregivers.ConclusionStudies reporting on interventions addressing loneliness and social isolation in nursing home residents need to clarify and detail their intervention mechanisms in order to foster more targeted interventions. In addition, there is a need for further research on large-scale programs or care philosophies in this field and the development of intervention designs, which allow for tailored intervention formats in order to respond to the individual perception of social relationships.

The grip strength loss rate and the subsequent cognitive decline rate in older adults: The moderating role of social isolation

Abstract Background and Objectives Accumulating evidence suggests that low grip strength (GS) was associated with a faster cognitive decline, but most previous studies have measured GS at a single time point, ignoring changes in GS. We aimed to explore the association of the GS loss rate with the sequent cognitive decline, as well as the moderating role of social isolation in older adults. Research Design and Methods Data were from the English Longitudinal Study of Ageing. Absolute and relative GS loss rates were calculated as the annual losses from wave 2 (2004–2005) to wave 4 (2008–2009). Participants were divided into three groups according to the tertiles of GS loss rates. Linear mixed models were used to assess the association of the GS loss rate during waves 2–4 with the cognitive decline rate during waves 4–9 (2018–2019). Results Of the 4356 participants included in analyses, 1938 (44.5%) were men, with a mean age of 68.4 (SD: 8.4) years. Compared with tertile 1 of the absolute GS loss rate, tertile 2 (β = -0.009 [95% CI: -0.018, -0.001] SD/year) and tertile 3 (β = -0.018 [95% CI: -0.027, -0.010] SD/year) were associated with a faster cognitive decline rate. The results of relative GS were similar to those of absolute GS. Social isolation was a significant modifier in the associations of the absolute GS loss rate with decline rates in global cognition and episodic memory, but not in temporal orientation. We did not observe that social isolation moderated the association of the relative GS loss rate with the cognitive decline rate. Discussion and Implications Both absolute and relative GS loss rates were positively associated with the cognitive decline rate in older adults. Low social isolation scores attenuated the association of the absolute GS loss rate with the cognitive decline rate.

Feasibility of a Telephone-Delivered Group Meditation Intervention for Chronically Ill Socially Isolated Older Adults

ABSTRACT Objectives This pilot study assessed the feasibility of a group-based telephone-delivered meditation intervention to reduce social isolation in older adults. It included weekly training sessions and daily practices of loving-kindness meditation in small groups via telephone conferences for six weeks and an extended group meditation practice for another six weeks. Methods Community-living older adults (age 60+) with multiple chronic conditions and experiencing social isolation were recruited. Each participant was assessed at the pretest, posttest, and follow-up (6 and 12 weeks after pretest). Outcome measures included social interaction, loneliness, and depressive symptoms. Open-ended questions were asked in the posttest and follow-up. Results Sixteen individuals enrolled, and fourteen completed the program (87.5% retention). Completers showed high levels of adherence (95% attendance to training) and acceptability and a statistically significant increase in social interaction at follow-up. Qualitative data suggest that participants experienced changes in emotion regulation, motivation and confidence, and sense of belonging. Conclusions A group-based telephone-delivered meditation intervention targeting chronically ill older adults who experience social isolation is technically feasible, very acceptable, and potentially beneficial to them. Clinical Implications Older adults enjoy learning meditation. Telephone conferencing is a low-cost tool for engaging socially isolated older adults in social interactions and group meditation.

Chronic loneliness and chronic social isolation among older adults: a study protocol for a systematic review, meta-analysis and meta-regression

IntroductionThere are around 20 studies identifying the prevalence of chronic loneliness and chronic social isolation in older adults. However, there is an absence of a systematic review, meta-analysis and meta-regression...

Examining the Effect of Contactless Intergenerational Befriending Intervention on Social Isolation Among Older Adults and Students' Attitude Toward Companionship: Content Analysis.

Intergenerational friendship, a mechanism of social support, is an effective intervention to reduce the increasing risk of social isolation (SI) and develop companionship in the older adult population. The COVID-19 pandemic provided a unique opportunity to examine the psychosocial intervention of befriending via technology use as a primary form of contactless socialization. The study aims to explore the effectiveness of the befriending intervention through a contactless, intergenerational service-learning project on older adult emotions, especially boredom and loneliness as the key attributes of SI, and on students' attitude toward companionship. During the months of January to April 2022 , undergraduate students enrolled in a health administration course with a special focus on culture were asked to be involved in a contactless, intergenerational service-learning project (n=46). In this study, contactless intervention meant communication using the telephone and apps such as FaceTime and Zoom. Students were paired with older adults to have at least a 30-minute weekly conversation, for 8 weeks, via telephone or an internet-based app such as FaceTime. Students were asked to write a half-page diary after each interaction and a 1-page reflection at the end of the fourth week and at the end of the service-learning project. At the completion of the project, the researchers also surveyed the older adults to assess the impact of the project using a 5-item open-ended questionnaire. Following a heuristic approach and content analysis, student artifacts (110,970 words; 118-page, single-spaced Microsoft Word document) and the older adult surveys were analyzed using MAXQDA, (VERBI GmbH). Qualitative data were extracted to assess the impact of service learning on SI by measuring the attributes of boredom and loneliness among 46 older adults. Students' attitudes toward companionship were also assessed using data from their diaries and reflections. Overall, three major constructs were identified: (1) meaningful engagement, defined as feeling safe, having increased confidence, and having reduced boredom; (2) internal motivation to participate in the weekly interaction, defined as discussion about daily life experience, level of happiness, and ability to exert personal control over the situation; and (3) intergenerational befriending, defined as perceived benefits from the friendly nature of the interaction, ability to comfortably connect with students, and positive feeling and attitude toward the student. The contactless, intergenerational befriending intervention reduced boredom and loneliness among older adults and enhanced positive attitude and confidence among university students. Students helped older adults to develop digital skills for the use of apps and social media. Older adults showed interest in the intervention and shared their daily life experiences with the students, which helped to reduce the gap between generations. Findings indicate the effectiveness of an intergenerational service-learning intervention on SI reduction and increased positive attitude among college students.

Racial and ethnic differences in predictors of participation in an intergenerational social connectedness intervention for older adults

BackgroundSocial connectedness is a key determinant of health and interventions have been developed to prevent social isolation in older adults. However, these interventions have historically had a low participation rate amongst minority populations. Given the sustained isolation caused by the COVID-19 pandemic, it is even more important to understand what factors are associated with an individual’s decision to participate in a social intervention. To achieve this, we used machine learning techniques to model the racial and ethnic differences in participation in social connectedness interventions.MethodsData were obtained from a social connectedness intervention that paired college students with Houston-area community-dwelling older adults (> 65 yo) enrolled in Medicare Advantage plans. Eligible participants were contacted telephonically and asked to complete the 3-item UCLA Loneliness Scale. We used the following machine-learning methods to identify significant predictors of participation in the program: k-nearest neighbors, logistic regression, decision tree, gradient-boosted decision tree, and random forest.ResultsThe gradient-boosted decision tree models yielded the best parameters for all race/ethnicity groups (96.1% test accuracy, 0.739 AUROC). Among non-Hispanic White older adults, key features of the predictive model included Functional Comorbidity Index (FCI) score, Medicare prescription risk score, Medicare risk score, and depression and anxiety indicators within the FCI. Among non-Hispanic Black older adults, key features included disability, Medicare prescription risk score, FCI and Medicare risk scores. Among Hispanic older adults, key features included depression, FCI and Medicare risk scores.ConclusionsThese findings offer a substantial opportunity for the design of interventions that maximize engagement among minority groups at greater risk for adverse health outcomes.

DID COVID-19 CHANGE REPORTS OF LONELINESS AND SOCIAL ISOLATION AMONG OLDER AMERICANS ACT CLIENTS?

Abstract COVID-19 raised immediate concern about the exacerbation of already high levels of loneliness and social isolation of older adults. Using the cross-sectional 2019 and 2021 National Survey of Older Americans Act Participants, we explored changes among selected populations of OAA clients – family caregivers (CGs), home-delivered meal clients (HDMs), and congregate meal clients (CMs). Descriptive statistics, t-tests, and review of 95% confidence intervals between years were conducted to understand rates of loneliness (UCLA 3-items) and social isolation (1-item). Results were not statistically significant but yield important findings. First, there were more cases of loneliness (48-70%) and social isolation (31-50%) than was known for the general older adult population before COVID-19. Second, the changes between 2019 and 2021 varied by service and gender. Among CGs, there was little difference in the cases of social isolation and loneliness from 2019 to 2021; however, male CGs reported a 20.3% increase in cases of social isolation. For HDMs there was a little difference over time in cases of social isolation and loneliness. There was a 23.3% increase in the number of CMs reporting social isolation and a small increase (9.3%) in CMs reporting loneliness; however, there was an 18.4% increase in cases of loneliness among male CMs. These results warrant further investigation to understand whether OAA services are a protective factor for social connections and further implementation of innovative approaches to lower overall rates of social isolation and loneliness among OAA clients.

LONGITUDINAL CHANGES IN WELL-BEING ASSOCIATED WITH AGING ATTITUDE, COGNITIVE STATUS, AND WIDOWHOOD TRANSITION

Abstract This symposium brings together four studies that employ national data collected from older Americans to examine longitudinal changes in older adults’ cognitive, social, and psychological health. The first study focuses on the role of self-perception of aging in memory decline and social mechanisms linking aging perception and memory. It found that negative perceptions of aging predicted memory decline 8 years later and that loneliness and social isolation were pathways. The second study is concerned with neuropsychological changes before the onset of dementia. Using latent growth modeling, it found that the trajectory of depression increased over time in a quadratic fashion before the onset of incident dementia. Further, there were racial/ethnic group differences in levels of depression. Using fixed-effect linear regression, the third study reports that changes in cognitive status were associated with changes in social isolation in older adults. Specifically, it found that transitioning from cognitive intact to cognitive impairment status was associated with increased social isolation. The fourth and final paper examines changes in psychological well-being related to the transition to widowhood. It found that during the year right after the spouse died, older adults experienced increased depressive symptoms and reduced positive well-being. But adaptation is evident—the surviving spouse returned to pre-loss levels of psychological well-being around two years after the death. Together, the four studies show that attitude, cognitive status, and life course transition shape the dynamics of cognitive, social, and psychological health in later life.

ADVANCING POSITIVE SOCIAL CONNECTIONS FOR OLDER ADULTS IN SUBSIDIZED HOUSING: A HUMAN-CENTERED DESIGN APPROACH

Abstract Social isolation is a complex problem that impacts many community-dwelling older adults and has detrimental impacts on mental and physical wellbeing of older adults. This research aims to utilize Human-Centered Design (HCD) to develop and implement tools and design ideas that advance positive social connections of older adults residing in subsidized housing. HCD is a collaborative process used to understand and define social problems, identify opportunities, generate ideas, and design interventions to support positive change. We sought to capture the perspectives and insights from older adults living in two federally subsidized housing communities in Baltimore, Maryland. During a five-month period, we held listening and brainstorming sessions with over 50 residents, service coordinators and members of management. Valuable insights and ideas were recorded during each of these facilitated engagements and synthesized. Through our engagements we identified six themes that influence the social connections of older adults living in subsidized housing: feelings of exclusion, lack of community connections, burdensome transitions to communal living, changes to building policies, and concerns about the physical environment. These themes led to the creation of interventions such as providing physical materials to residents, facilitating cultural inclusion and connections, implementing effective engagement strategies for community coordinators and promoting resident leadership. HCD can be employed to develop tools and innovative opportunities that specifically target and address social isolation in older adults living in subsidized housing. HCD can be utilized to drive changes to policies that impact older adults in subsidized housing leading to social transformations to improve health.

FUNCTIONAL LIMITATIONS, LIVING ARRANGEMENT, DAILY SOCIAL CONTACTS, AND LONELINESS IN LATE LIFE

Abstract Older adults with functional limitations are at a greater risk of social isolation and loneliness, largely due to difficulties in mobility and compromised social contacts. Lack of social contact throughout the day may contribute to loneliness among older adults with functional limitations, and these associations may differ by living arrangements. This study examined associations between functional limitations, living alone, daily social contacts, and loneliness throughout the day. Community-dwelling older adults aged 65 + (N = 310, Mage = 73.96) from the Daily Experiences and Well-being Study completed a measure of functional limitations in a baseline interview. Then, in ecological momentary assessments (EMA), they reported social contacts and loneliness every 3 hours for 5 to 6 days. Multilevel models revealed a significant interaction between functional limitations and social contacts on loneliness, such that people with higher levels of functional limitations felt less lonely if they had more social contacts in the prior 3 hours, but not for those with lower levels of functional limitations. The three-way interaction between functional limitations, living alone, and loneliness revealed that more social contacts were associated with reduced loneliness only among individuals with functional limitations and who lived with others. Individuals with functional limitations who lived alone had higher levels of loneliness than those with functional limitations who lived with others. The findings emphasize the vulnerability in social isolation of older adults with functional limitations, especially those who live alone. Yet this vulnerable group may also benefit more from adequate daily social contacts.

Friendly visiting by a volunteer for reducing loneliness or social isolation in older adults: A systematic review.

Loneliness and social isolation are currently among the most challenging social issues. Given their detrimental impact on physical and mental health, identifying feasible and sustainable interventions to alleviate them is highly important. Friendly visiting, a befriending intervention whereby older persons are matched with someone who visits them on a regular basis, seems promising. However, it is unclear if face-to-face (F2F) friendly visiting by a volunteer (FVV) is effective at reducing loneliness or social isolation, or both. To assess the effect of F2F FVV on feelings of loneliness, social isolation (primary outcomes) and wellbeing (i.e., life satisfaction, depressive symptom experiencing and mental health; secondary outcomes) in older adults. We searched six electronic databases up until 11 August 2021. We also consulted 15 other resources, including grey literature sources and websites of organizations devoted to loneliness and ageing, between 25 October and 29 November 2021. We included experimental and observational studies that quantitatively measured the effect of F2F FVV, compared to no friendly visiting, on at least one of following outcomes in older adults (≥60 years of age): loneliness, social isolation or wellbeing. Two reviewers independently performed study selection, data extraction and synthesis, risk of bias and GRADE assessment. If outcomes were measured multiple times, we extracted data for one short-term (≤1 month after the intervention had ended), one intermediate-term (>1 and ≤6 months), and one long-term time point (>6 months). Data from randomized controlled trials (RCTs) and non-RCTs were presented and synthesized separately. Synthesis was done using vote counting based on the direction of effect. Nine RCTs and four non-RCTs, conducted primarily in the United States and involving a total of 470 older adults (mean or median ages: 72-83 years), were included. All studies were limited in size (20-88 participants each). Programmes lasted 6-12 weeks and mostly involved weekly visits by undergraduate students to community-dwelling older adults. Visits consisted mainly of casual conversation, but sometimes involved gameplaying and TV-watching. All studies had major shortcomings in design and execution. The current evidence about the effect of F2F FVV on loneliness in older adults is very uncertain, both in the short (one RCT in 88, and one non-RCT in 35 participants) and intermediate term (one RCT in 86 participants) (both very low-certainty evidence). The same goes for the effects on social isolation, again both in the short (one RCT in 88, and two non-RCTs in 46 participants) and intermediate term (two non-RCTs in 99 participants) (both very low-certainty evidence). Similarly, there is a lot of uncertainty about the effect of F2F FVV on outcomes related to wellbeing (all very low-certainty evidence). Due to the very low-certainty evidence, we are unsure about the effectiveness of F2F FVV with regard to improving loneliness, social isolation, or wellbeing in older adults. Decision-makers considering implementing FVV should take into account this uncertainty. More and larger high-quality studies that are better designed and executed, and preferably conducted in various settings, are needed.

Risk factors for social isolation in older adults: A systematic review and meta-analysis.

To explore the risk factors of social isolation in older adults by meta-analysis. We examined articles that had been published on the China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service platform, VIP Periodical Chinese Journal Service platform, Medical Literature database, PubMed, Embase database, Chinese BioMedical Literature database (CBM), and the Cochrane Library. RevMan 5.3 software was used for meta-analysis. A total of 13 pieces of literature comprising 47,288 patients were included, including five in Chinese and eight in English. According to our review, the common risk factors reported were age, sex, education level, marital status, self-rated health status, depression, social support, cognitive function, and basic diseases. Gender (female), education level (lower education level), marital status (divorced), self-rated health status (poor), depression, lack of social support, inadequate cognitive function, and underlying disorders were the key risk factors for social isolation in older adults. To reduce social isolation in older adults, paying more attention to the aging population with poor marital statuses, low education levels, poor health statuses, depression, poor cognitive function, and other underlying diseases is necessary. It is essential to encourage patients and their family members to participate in social activities and build a multi-social support system to reduce social isolation in older adults.

Characterizing different patterns of digital competence and their associations with loneliness and social isolation among older adults: findings from South Korea

Objectives With the advent of worldwide internet networks in the digital age, digital competence can play an important role in decreasing loneliness and social isolation in older adults. This study characterized different patterns of digital competence among older adults and examined their associations with loneliness and social isolation Method The sample included 315 older Korean adults (M = 68.79, range = 65–84) who completed an online survey. Results Latent profile analysis identified four different profiles of digital competence, including 1) low activity (28%) who did not choose digital participation despite advanced technical skills, 2) unskilled (13%) who had limited technical skills, 3) passive participation (25%) who was motivated for digital interactions even with insufficient technical skills, and 4) active participation (34%) who were involved in digital activities with the necessary skills. Additionally, the unskilled profile had relatively higher levels of loneliness than did the active participation profile. The passive participation and low activity profiles showed the highest level of social isolation, followed by the unskilled, and active participation profiles. Conclusion The present findings suggest that understanding different profiles of digital competence and facilitating active digital participation related to specific profiles can be an effective strategy to reduce older adults’ social isolation and loneliness.

Interpersonal touch and the importance of romantic partners for older adults’ neuroendocrine health

Interpersonal touch is an essential aspect of human interaction that has the ability to regulate physiological stress responses. Prolonged exposure to stress can have cumulative multiphysiological effects; for example, allostatic load. Despite the increased susceptibility of social isolation for older adults, there is a paucity of research on the efficacy of touch in regulating stress responses among this population. It is also unknown whether touch confers benefits regardless of the person with whom it is shared. This study investigates the difference in physiological stress based on the frequency of touch (hugs, holding, or other close physical contact) shared with romantic partners as compared to other close adults (family, friends, and neighbours) in an older adult population. Data were analysed from 1419 respondents (aged 57–85 years) of the National Social Life, Health, and Aging Project (NSHAP) in 2005–2006. Principal components analysis determined whether the eight markers of allostatic load measured in the NSHAP function as a singular system or as distinct components. Analyses revealed three components of allostatic load: metabolic, cardiovascular, and neuroendocrine health. The results of multiple regression revealed that a higher frequency of interpersonal touch shared with romantic partners was associated with better neuroendocrine health (β = 0.13, p = 0.004) following adjustment for a variety of covariates (but not with better metabolic or cardiovascular health), with no associations apparent for touch from other close adults. These findings highlight the importance of promoting interpersonal touch with romantic partners for older adults’ neuroendocrine health.

Combating Social Isolation in Older Adults: An Intergenerational Nursing Communication Project.

The importance of social connection to health and well-being has long been recognized. Social isolation is prevalent and impactful in the lives of older adults across care settings. A semester-long communication-focused clinical project was developed and piloted with sophomore Bachelor of Nursing Science students during Fall 2020 and replicated in Fall 2021 and 2022. Students were paired with older adult volunteers/mentors from a senior living organization and contacted mentors every 2 weeks over the 15-week semester. Older adult volunteers served as mentors, sharing their wisdom and life experiences. Students practiced their communication skills and learned about their mentor's life. Pre- and post-activity surveys of student attitudes toward older adults/aging suggested a dramatic and positive shift in perspective, and mentors rated the experience highly favorably. Intergenerational communication and relationship building has the potential to combat social isolation, promote healing and growth, and enable mutually beneficial engagement. [Journal of Psychosocial Nursing and Mental Health Services, 61(10), 7-11.].

366 Patient Preferences for Social Interventions to Reduce Social Isolation in Older Adults Discharged From the Emergency Department

366 Patient Preferences for Social Interventions to Reduce Social Isolation in Older Adults Discharged From the Emergency Department

An ethnography study exploring factors that influence social isolation in care home residents living with dementia and hearing loss

BackgroundHearing loss and dementia are highly prevalent conditions amongst older adults living in residential care. The consequences of living with these conditions may include social withdrawal and reduced communication opportunities. We sought to examine patterns of communication and interaction in residential care and explore resident, staff, and relative perspectives within two care homes located in Birmingham, UK. This enabled an understanding of how communication environments contributed to social isolation.MethodsThis work used ethnography methodology to explore mechanisms that created and maintained social isolation in older adults living with dementia and hearing loss. A planning and engagement phase took place in four care homes. This was followed by an environmental audit, observations, and interviews. Data generated were analysed using Grounded Theory methods.ResultsThere were 33 participants (16 residents, 11 care staff, and six relatives) who took part in the observations and interviews. Residents experienced social isolation through lack of meaningful conversation with others and being misunderstood. Additionally, observations of residents’ interactions informed the overall findings. A Grounded Theory model was employed to explain the core phenomenon of social isolation. The main contributors were internal and external barriers to communication, and reduced opportunities for meaningful conversation.ConclusionsThere is a wide range of social isolation that care home residents experience. This was not always associated with the severity of hearing loss but rather communication ability. Simple interventions such as staff dining with residents and focussing on improving communication could reduce social isolation within residential care settings.

Social Isolation of Older Adults, Family, and Formal Caregivers During the COVID-19 Pandemic: Stories and Solutions Through Participatory Action Research.

This participatory action research (PAR) aimed to understand the health implications of guidelines impacting social isolation among frail community-dwelling older adults and their family and formal caregivers during the coronavirus disease (COVID-19) pandemic. Reflexive thematic analysis (RTA) of data collected from 10 policy/procedural documents revealed four themes: valuing principles, identifying problem(s), setting priorities, and making recommendations. Interviews with 31 participants from Peterborough, Ontario, also revealed four themes: sacrificing social health, diminishing physical health, draining mental health, and defining supports. Recommendations to decision makers were finalized at a knowledge exchange event involving participants and members of Age-friendly Peterborough. Key findings demonstrate the need for Canadian governments and health and social service agencies to enhance access to technology-based interventions, and educational and financial resources for caregivers. Meaningful communication and collaboration between older adults, caregivers, and decision makers are also needed to reduce the gap between policy and practice when addressing social isolation.

Loneliness and Depressive Symptoms Are High Among Older Adults With Digestive Disease and Associated With Lower Perceived Health

Current approaches to managing digestive disease in older adults fail to consider the psychosocial factors contributing to a person's health. We aimed to compare the frequency of loneliness, depression, and social isolation in older adults with and without a digestive disease and to quantify their association with poor health. We conducted an analysis of Health and Retirement Study data from 2008-2016, a nationally representative panel study of participants 50 years and older and their spouses. Bivariate analyses examined differences in loneliness, depression, and social isolation among patients with and without digestive disease. We also examined the relationship between these factors and health. We identified 3,979(56.0%) respondents with and 3,131(44.0%) without a digestive disease. Overall, 60.4% and 55.6% of respondents with and without digestive disease reported loneliness(p<0.001), 12.7% and 7.5% reported severe depression(p<0.001), 8.9% and 8.7% reported social isolation(p=NS), respectively. After adjusting for covariates, those with a digestive disease were more likely to report poor-or-fair health than those without digestive disease (OR 1.25,95%CI 1.11,1.41). Among patients with a digestive disease, loneliness (OR 1.43,95%CI 1.22,1.69) and moderate and severe depression (OR 2.93,95%CI 2.48,3.47; OR 8.96,95%CI 6.91,11.63) were associated with greater odds of poor-or-fair health. Older adults with a digestive disease were more likely than those without a digestive disease to endorse loneliness and moderate-to-severe depression and these conditions are associated with poor-or-fair health. Gastroenterologists should feel empowered to screen patients for depression and loneliness symptoms and establish care pathways for mental health treatment.