Loneliness as a mediator of the impact of social isolation on cognitive functioning of Chinese older adults

Yang, Rumei; Wang, Haocen; Edelman, Linda S.; Tracy, Eunjin Lee; Demiris, George; Sward, Katherine; Donaldson, Gary

doi:10.1093/ageing/afaa020

Cited by 78 publications

(69 citation statements)

References 28 publications

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“…12 And while these are two distinct entities that are inherently difficult to study, literature suggests that they are related, just not directly overlapping. 13 The prevalence of loneliness is difficult to understand, and a variety of tools have been developed to assess for loneliness including the de Jong Gierveld (dJG) Loneliness scale and UCLA Loneliness scale. 14,15 Perissinotto et al showed that 29% of respondents over 75 years old were lonely, while the American Association of Retired Persons (AARP) found about 25% of respondents over 70 years old were lonely; both using the UCLA Loneliness Scale.…”

Section: The Realitymentioning

confidence: 99%

COVID‐19 in the geriatric population

Roy

Jain

Golamari

et al. 2020

Int J Geriat Psychiatry

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The global COVID-19 pandemic has caused rapid and monumental changes around the world. Older people, who already experience higher rates of social isolation and loneliness, are more susceptible to adverse effects as a result of the social distancing protocols enacted to slow the spread of COVID-19. Based on prior outbreaks, we speculate the detrimental outcomes and offer solutions. Methods: Reviewing the literature on the detrimental effects of social isolation and loneliness and higher mortality in the older population. Utilizing psychological study outcomes from prior major outbreaks such as in SARS, Ebola, H1N1 influenza, and Middle East respiratory syndrome offer predictions and the susceptibility in the geriatric age group. Results: Organizations such as the WHO, Centers for Disease Control, and American Association of Retired Persons have put measures in place to provide networking on a local, regional, and national level. These efforts are designed to start mitigating such detrimental effects. A necessary follow-up to this pandemic will be gathering data on unique populations such as the geriatric community, to better mitigate adverse outcomes given the certainty that COVID-19 will not be the last global viral outbreak. Conclusions: The results of worsened social isolation and loneliness is associated with significantly increased morbidity and mortality in the geriatric population. Various solutions including virtual interactions with loved ones, engaging in physical activity, continuing any spiritual or religious prayers remotely, and community services to provide aid for the older population are all efforts to minimize social isolation and loneliness.

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Section: The Realitymentioning

confidence: 99%

COVID‐19 in the geriatric population

Roy

Jain

Golamari

et al. 2020

Int J Geriat Psychiatry

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“…It is important to observe that one of the mechanisms by which isolation may have an impact on the psychological aspects of an individual is through the role of loneliness as a mediator. This has been demonstrated, for example, in older adults, where the effect of social isolation on cognitive function decline was found to be influenced by the indirect effect of loneliness [21]. This means that, even if constrained within a context of isolation, if a person can maintain social relations and cope with feelings of loneliness, this can potentially mitigate the impact on mental health.…”

Section: Discussionmentioning

confidence: 93%

Conducting research in Radiation Oncology remotely during the COVID-19 pandemic: Coping with isolation

Dhont

Tella

Dubois

et al. 2020

Clinical and Translational Radiation Oncology

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Introduction: With the COVID-19 pandemic, individuals have been forced to follow strict social isolation guidelines. While crucial to control the pandemic, isolation might have a significant impact on productivity and mental health. Especially for researchers working in healthcare, the current situation is complex. We therefore carried out a survey amongst researchers in the field of radiation oncology to gain insights on the impact of social isolation and working from home and to guide future work. Materials and methods: An online survey was conducted between March 27th and April 5th, 2020. The first part contained 14 questions intended to capture an overview of the specific aspects related to research while in isolation. The second (optional) part of the questionnaire was the validated Hospital Anxiety and Depression Scale (HADS), a self-reported measure used to assess levels of anxiety and depressive symptoms. Results: From 543 survey participants, 48.8% reported to work full-time from home. The impact on perceived productivity, with 71.2% of participants feeling less productive, caused 58% of participants to feel some level of guilt. Compared to normative data, relatively high levels of anxiety and depressive symptoms were recorded for the 335 participants who filled out the HADS questionnaire. Group comparisons found the presence of a supportive institutional program as the sole factor of statistical significance in both anxiety and depressive symptom levels. People having to work full-time on location showed higher depressive symptom levels than those working from home. Anxiety scores were negatively correlated with the number of research years. Conclusion: Results of the survey showed there is a non-negligible impact on both productivity and mental health. As the radiation oncology research community was forced to work from home during the COVID-19 pandemic, lessons can be learned to face future adverse situations but also to improve work-life balance in general.

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“…In addressing the objective and subjective aspects of social disconnectedness, it is plausible to hypothesize that the effect of social isolation on cognitive health may be mediated through the subjective feelings of loneliness. Using a sample of community-dwelling older adults in China, Yang and colleagues [13] provided support for this mediation model by demonstrating that the indirect effect of social isolation on cognitive function through loneliness was significant. Given that their study used a set of binary items to construct a latent variable of social isolation and a single item to represent loneliness, the mediation model needs to be revisited with the employment of psychometrically sound multi-item scales for social isolation and loneliness.…”

Section: Introductionmentioning

confidence: 96%

“…We also explore whether the potential mediating role of loneliness in the relationship between social isolation and cognitive health holds across the objective and subjective measures of cognitive impairment. Covariates were selected based on the literature on social disconnectedness and cognitive health in older adults in general and immigrants in particular, and they include sociodemographic characteristics (age, gender, marital status, education, and perceived financial status), immigration-related characteristics (length of stay in the U.S.), and physical and mental health status (chronic medical conditions and depressive symptoms) [6,7,12,13,18,23]. Inclusion of chronic medical conditions and depressive symptoms is in line of the literature demonstrating the interconnectedness among physical, mental, and cognitive health [17,24].…”

Section: Introductionmentioning

confidence: 99%

Cognitive health risks posed by social isolation and loneliness in older Korean Americans

et al. 2021

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Background This study examines associations among social isolation, loneliness, and cognitive health risks in older Korean Americans, focusing on the mediating role of loneliness in the relationship between social isolation and objective and subjective measures of cognitive impairment. Methods Data are from 2061 participants in the Study of Older Korean Americans, a multi-state survey of Korean immigrants age 60 and older (Mage = 73.2, SD = 7.93). Social isolation was indexed with the Lubben Social Network Scale− 6; loneliness, with the short-form UCLA Loneliness Scale. Objective and subjective measures of cognitive impairment included the Mini-Mental State Examination and a single-item self-rating of cognitive health. Results In the logistic regression model for objective cognitive impairment, social isolation was significantly associated, but loneliness was not. In the model for subjective cognitive impairment, both social isolation and loneliness were significant factors. However, the effect of social isolation became non-significant when loneliness was considered, suggesting a potential mediating role of loneliness. The subsequent mediation analysis confirmed that the indirect effect of social isolation on subjective cognitive impairment through loneliness was significant (B = .20, SE = .03, 95% CI = .12, .28). Conclusion Our analyses provide evidence for the proposed mediating effect of loneliness in the relationship between social isolation and subjective cognitive impairment. Intervention efforts should focus on reducing feelings of loneliness experienced by older immigrants, possibly by engaging them in socially meaningful and cognitively stimulating activities.

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Loneliness as a mediator of the impact of social isolation on cognitive functioning of Chinese older adults

Cited by 78 publications

References 28 publications

COVID‐19 in the geriatric population

COVID‐19 in the geriatric population

Conducting research in Radiation Oncology remotely during the COVID-19 pandemic: Coping with isolation

Cognitive health risks posed by social isolation and loneliness in older Korean Americans

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