The longitudinal relationship between loneliness, social isolation, and frailty in older adults in England: a prospective analysis

Davies, Keith A.; Maharani, Asri; Chandola, Tarani; Todd, Chris; Pendleton, Neil

doi:10.1016/s2666-7568(20)30038-6

Cited by 99 publications

(86 citation statements)

References 27 publications

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“…Social isolation and loneliness have been linked to reduced physical functioning and frailty in older adults [ 17 ] and identified as risk factors for frailty onset and progression [ 19 , 20 ]. To promote social participation and reduce loneliness, consideration will be given to referring participants to available local group activities as needed.…”

Section: Discussionmentioning

confidence: 99%

A multifactorial interdisciplinary intervention to prevent functional and mobility decline for more participation in (pre-)frail community-dwelling older adults (PromeTheus): study protocol for a multicenter randomized controlled trial

et al. 2022

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Background Age-related decline in physical capacity can lead to frailty, associated with an increased vulnerability to adverse health outcomes and greater healthcare utilization. In an aging population, effective strategies to prevent physical decline and frailty, and preserve independence are needed. Prevention programs for vulnerable community-dwelling older adults are, however, often not yet established and implemented in routine practice. Research on the feasibility, implementation, and (cost-)effectiveness of multifactorial, interdisciplinary intervention programs that take advantage of available services of healthcare providers is also limited. The main aim of this study is to evaluate the effectiveness of such an intervention program (PromeTheus) to prevent functional and mobility decline for more participation in community-dwelling (pre-)frail older adults. Methods The study is designed as a three-center, randomized controlled trial with a 12-month intervention period. Four hundred community-dwelling (pre-)frail (Clinical Frailty Scale score 4–6) older adults (≥70 years) will be randomized in a 1:1 ratio to the intervention group (IG) or the control group (CG). The IG will receive the PromeTheus program consisting of obligatory home-based physical exercises (Weight-bearing Exercise for Better Balance) accompanied by physiotherapists and facultative counseling services (person-environment-fit, coping with everyday life, nutrition, group-based activities) delivered via existing healthcare structures (e.g., social workers, nutritionists). The CG will receive usual care and a one-time counseling session on recommendations for physical activity and nutrition. Primary outcomes assessed at months 6 and 12 are the function component of the Late-Life Function and Disability Instrument and the University of Alabama at Birmingham Life-Space Assessment. Secondary outcomes are disability, physical capacity and activity, frailty, nutritional status, falls, fear of falling, health status, and psychosocial components. Process and economic evaluations are also conducted. Primary statistical analyses will be based on the intention-to-treat principle. Discussion Compared to usual care, the PromeTheus program is expected to result in higher function and mobility, greater independence and lower need for care, and more participation. As the PromeTheus program draws on existing German healthcare structures, its large-scale translation and delivery will be feasible, if evidence of (cost-)effectiveness and successful implementation can be demonstrated. Trial registration German Clinical Trials Register, . Registered on March 11, 2021.

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Section: Discussionmentioning

confidence: 99%

A multifactorial interdisciplinary intervention to prevent functional and mobility decline for more participation in (pre-)frail community-dwelling older adults (PromeTheus): study protocol for a multicenter randomized controlled trial

et al. 2022

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“…The conceptualization of social isolation of seniors varies considerably across different disciplines with no clear consensus on either the definition or the best way to measure social isolation. 21,22 Some researchers consider that indicators of social isolation require more objectivity including dimensions such as the number and frequency of social contacts or meaningful ties and fulfilling relationships. [23][24][25] This is interconnected with indicators of loneliness which are typically more subjective including, for example, an assessment of people's feelings and cognitions surrounding the quantity and quality of social contacts and relationships.…”

Section: Conceptualization and Measurement Challengesmentioning

confidence: 99%

“…Cross-cultural variation should be also considered in developing measures of social isolation. 21, 39 Biordi and Nicholson 40 suggest that a cultural screening should be built into social isolation measures in order to recognize the differences among cultures in terms of how social relations are organized. Hossen 37 suggests that in some cultures, collectivism or family orientation is more highly valued than individualism and that this may not necessarily fit with the prevailing values in the host country.…”

Section: Cultural Differencesmentioning

confidence: 99%

Competing challenges for immigrant seniors: Social isolation and the pandemic

Johnson

Bacsu

McIntosh

et al. 2021

Healthc Manage Forum

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The pandemic has exposed and amplified complex and complicated health and societal challenges while offering immense opportunities to transform societies to improve health for all. Social isolation is a challenging and persistent issue experienced by many older adults, especially among immigrant and refugee seniors. Unique risk factors such as racism, discrimination, language barriers, weak social networks, and separation from friends and family predispose immigrant and refugee seniors to a higher risk of social isolation. The pandemic has magnified the unique risks and has highlighted the differential health and economic impacts. This article examines social isolation among immigrant and refugee seniors in Canada by focusing on the policy context, available programs and services to reduce social isolation, and the conceptualization and measurement considerations for advancing research to address social isolation among this growing population. Drawing on specific examples, we discuss immigration, aging, and social isolation within the context of Canada. While our article focuses on Canada as a case study, our discussion has relevancy and implications for other high-income countries with aging immigrant and refugee populations. In moving forward, we argue that a more complete and targeted understanding of social isolation is essential to informing program and policy development to support immigrant and refugee seniors in Canada and beyond. The transformation needed in our societies to create health for all requires strong equity and determinants of health perspective and a systems approach beyond health to ensure lasting change.

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“…Tele-psychotherapy can overcome some of the barriers that prevent older adults and the general public from turning to psychotherapy, such as physical limitations, lack of transportation, financial difficulties, and social stigma [ 37 , 38 , 39 ]. This is extremely important in the case of older adults whose mobility difficulties can lead to social isolation, which is associated with a decline in mental health [ 40 , 41 ]. Sometimes, patients feel more comfortable when engaging in therapy from their homes [ 42 ].…”

Section: Introductionmentioning

confidence: 99%

Crafting Life Stories in Photocollage: An Online Creative Art-Based Intervention for Older Adults

Keisari

Piol

Elkarif

et al. 2021

Behavioral Sciences

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Creative arts therapies (CAT) provide a safe and creative environment for older adults to process life experiences and maintain personal growth while aging. There is a growing need to make creative arts therapies more accessible to the aging population, as many have limited access to these services. This need has been catalyzed by the advent of the COVID-19 pandemic. Tele-CAT offers a possible solution. This study explored the experiences of older adults who participated in an online creative process of digital photocollage based on CAT. Twenty-four Italian and Israeli community-dwelling older adults aged 78 to 92 participated in this research through Zoom teleconferencing software. Transcriptions of the sessions and the art produced through the photocollage were qualitatively analyzed through Thematic Analysis. The findings show that the projective stimuli of digital photographs supported older adults’ narratives and engaged them in a more embodied emotional experience. Participant experiences involved artistic enjoyment within a positive and safe interaction with therapists. The creation of digital photocollages allowed the participants to process their life experiences and create an integrative view of their life, a vital developmental task in late life. These results point to the advantages and challenges of tele-CAT for older adults.

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The longitudinal relationship between loneliness, social isolation, and frailty in older adults in England: a prospective analysis

Cited by 99 publications

References 27 publications

A multifactorial interdisciplinary intervention to prevent functional and mobility decline for more participation in (pre-)frail community-dwelling older adults (PromeTheus): study protocol for a multicenter randomized controlled trial

A multifactorial interdisciplinary intervention to prevent functional and mobility decline for more participation in (pre-)frail community-dwelling older adults (PromeTheus): study protocol for a multicenter randomized controlled trial

Competing challenges for immigrant seniors: Social isolation and the pandemic

Crafting Life Stories in Photocollage: An Online Creative Art-Based Intervention for Older Adults

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