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Effects of transient and chronic loneliness on major depression in older adults: a longitudinal study
- Authors:
- MARTIN-MARIA Natalia, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(1), 2021, pp.76-85.
- Publisher:
- Wiley
Objectives: The number of older adults is rapidly rising globally. Loneliness is a common problem that can deteriorate health. The aims of this work were to identify different types of loneliness (transient and chronic) and to assess their association with depression over time. Methods: A nationally representative sample from the Spanish population comprising 1190 individuals aged 50+ years was interviewed on three evaluations over a 7‐year period. The UCLA Loneliness Scale was used to measure loneliness. While chronic loneliness was defined as the presence of loneliness across all three waves, transient loneliness expressed the presence of loneliness in one wave only. A 12‐month major depressive episode was assessed at each interview. After confirming the cross‐sectional relationship, a multilevel mixed‐effects model was used to examine the association between loneliness and depression. Results: Almost a quarter of individuals felt lonely and one out of 10 presented depression at baseline. Of the sample, 22.78% showed transient loneliness, while 6.72% presented the chronic type. People experiencing chronic loneliness were at a higher risk of presenting major depression (OR = 6.11; 95% CI = 2.62, 14.22) than those presenting transient loneliness (OR = 2.22; 95% CI = 1.19, 4.14). This association varied over time and was stronger at the first follow‐up than at the second one. Conclusions: Focusing on loneliness prevention could reduce the risk of depression. Chronic loneliness is a public health problem that should be addressed through the full participation of the political, social, and medical sectors. (Edited publisher abstract)
Are loneliness and social isolation associated with cognitive decline?
- Authors:
- LARA Elvira, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 34(11), 2019, pp.1613-1622.
- Publisher:
- Wiley
Objective: This study aimed to examine the association of loneliness and social isolation on cognition over a 3‐year follow‐up period in middle‐ and older‐aged adults. Methods: Data from a Spanish nationally representative sample were analyzed (n = 1691; aged 50 years or older). Loneliness, social isolation, and cognition (immediate recall, delayed recall, verbal fluency, forward digit span, backward digit span, and a composite cognitive score) were assessed both at baseline and at follow‐up. Adjusted generalized estimating equations models were performed. Results: Loneliness was significantly associated with lower scores in the composite cognitive score, immediate and delayed recall, verbal fluency, and backward digit span (B = −0.14 to B = −3.16; P < .05) and with a more rapid decline from baseline to follow‐up in two out of six cognitive tests. Higher social isolation was associated with lower scores in the composite cognitive score, verbal fluency, and forward digit span (B = −0.06 to B = −0.85; P < .05). The effect of loneliness and social isolation on cognition remained significant after the exclusion of individuals with depression. Conclusions: Both loneliness and social isolation are associated with decreased cognitive function over a 3‐year follow‐up period. The development of interventions that include the enhancement of social participation and the maintenance of emotionally supportive relationships might contribute to cognitive decline prevention and risk reduction. (Publisher abstract)
Loneliness and the exchange of social support among older adults in Spain and the Netherlands
- Authors:
- RODRIGUEZ Sanchez Marta M., de JONG GIERVELD Jenny, BUZ Jose
- Journal article citation:
- Ageing and Society, 34(2), 2014, pp.330-354.
- Publisher:
- Cambridge University Press
Previous research has shown that exchanges of support within social networks reduce the loneliness of older adults. However, there is no consistent evidence on how types of support (instrumental and emotional) and the direction of that support (giving and receiving) are related to loneliness, and whether the effects are culture-specific. The aim of this study was to investigate support exchanges and their effects on loneliness in Spain and the Netherlands. The authors suggest that cultural differences, such as more interdependent cultural values in Southern Europe and more independence-related values in Northern Europe, influence social realities such as the social support exchanged. In Spain relationships with family members are determined by mutual obligations; older people expect to receive instrumental support from them. However, in Northern Europe independence is highly valued and intimacy and closeness are shown primarily by confiding about personal matters. This paper examined data from two comparable surveys, one in Spain (N=646) and one in the Netherlands (N=656). Older adults in Spain provide for, and receive, high amounts of instrumental support and this proved to be a protective factor against loneliness. An alternative pattern was found in the Netherlands where respondents provided more and received more emotional support than Spanish older adults; emotional support is a protective factor in the Netherlands (but only for support received). (Edited publisher abstract)
Qualitative evaluation of a community‐based intervention to reduce social isolation among older people in disadvantaged urban areas of Barcelona
- Authors:
- LAPENA Carolina, et al
- Journal article citation:
- Health and Social Care in the Community, 28(5), 2020, pp.1488-1503.
- Publisher:
- Wiley
This study analyses participants' and coordinators' perceptions of the implementation process and perceived benefits of a community‐based intervention to reduce social isolation among older adults. The ‘School of Health for Older People’ is a weekly community intervention that promotes resources among individuals and communities in order to enhance their ability to identify problems and activate solutions, encouraging participation in the community. A qualitative approach was employed, based on semi‐structured interviews and focus groups (FGs). This study was carried out in Barcelona. Two coordinators (community nurses) and 26 community‐dwelling people aged 65 and over who attended the School of Health for Older People in the neighbourhoods of Besòs and Guineueta, participated in in‐depth interviews and FGs between January and February 2016. Views and experiences about the intervention were explored. The main perceived effects of the intervention were expanding knowledge of health issues and of community activities, encouraging participants to go out, giving them a feeling of being heard, and peer relationships, increasing participants' contacts and knowledge while the main negative features were related to repetition of certain contents. The benefits identified included learning something about health and their own neighbourhood and breaking the habit of staying at home. Social isolation might be prevented by increasing the number of contacts with peers and sharing a common interest, since it could help to give them a sense of belonging to a community. (Publisher abstract)
Health status and well-being of older adults living in the community and in residential care settings: are differences influenced by age?
- Authors:
- RODRIGUEZ-BLAZQUEZ Carmen, et al
- Journal article citation:
- Aging and Mental Health, 16(7), September 2012, pp.884-891.
- Publisher:
- Taylor and Francis
This study investigated factors influencing health status and well-being variables between institutionalised and non-institutionalised older adults, as well as the interaction effect of institutionalisation and age. Data on a total of 468 older adults from ten Spanish provinces were analysed. Socio-demographic variables and measures on well-being, health status, functional ability, depression, loneliness and comorbidity were used. Significant differences in health status variables, but not in well-being were detected between groups. Controlling for age, differences in health status were found to be not significant in both groups. In the non-institutionalised group, people aged 78 years or more reported a significantly lower well-being than younger counterparts. Analysis showed that depression, functional dependence, loneliness and sex were associated with health status, while depression, health status, loneliness and the interaction of age-institutionalisation were related to well-being. The results suggest that age influences community-dwelling older adults' well-being to a greater extent than it does to institutionalised older people. Implications for practice are discussed.
Promoting social capital to alleviate loneliness and improve health among older people in Spain
- Author:
- COLL-PLANAS Laura
- Journal article citation:
- Health and Social Care in the Community, 25(1), 2017, pp.145-157.
- Publisher:
- Wiley
Loneliness is especially frequent among older people in Southern Europe. Furthermore, promoting social capital to tackle loneliness and its health effects is an understudied intervention strategy. Therefore, a complex intervention was piloted in Spain in a pre–post study with a 2-year follow-up. Its aims were to explore the feasibility of the intervention and its short- and long-term effects. It was conducted in one mixed rural–urban and two urban areas of diverse socioeconomic levels from 2011 to 2012. The intervention framework was based on social capital theory applying a behaviour change model and care co-ordination. The intervention comprised: (i) a co-ordinated action aimed at building a network between primary healthcare centres and community assets in the neighbourhood and (ii) a group-based programme, which promoted social capital among lonely older people, especially social support and participation. Older people active in senior centres volunteered as gatekeepers. The main outcome domain was loneliness. Secondary outcome domains were participation, social support, self-perceived health, quality of life, depressive symptoms and use of health resources. Pre–post changes were assessed with t-test, Wilcoxon signed-rank test and McNemar's test. Differences between the three time points were assessed with a one-way ANOVA with repeated measures. Social workers and nurses were successfully involved as group leaders, 10 volunteers took part and 38 participants were included. After the intervention, loneliness decreased while social participation and support significantly increased. Furthermore, the number of visits to nurses increased. Exactly 65.8% of the participants built social contacts within the group and 47.4% became engaged in new activities. Two years later, social effects were maintained and depressive symptoms had decreased. Exactly 44.7% of the participants continued to be in contact with at least one person from the group and 39.5% continued participating. The intervention contributes a novel and feasible social capital-based approach for alleviating loneliness among older adults while prompting meaningful changes in their lives. (Publisher abstract)