Search Advanced

AIMS Public Health

2020, Volume 7, Issue 3: 521-534. doi: 10.3934/publichealth.2020042
Previous Article Next Article
Research article

Associations among living alone, social support and social activity in older adults

  • Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
  • Received: 10 May 2020 Accepted: 08 July 2020 Published: 14 July 2020

  • Objectives We examined cross-sectional associations of living alone with social isolation among community-dwelling older adults in Worcester County, Massachusetts, USA.
    Methods Four hundred participants 65 years old and older were recruited in community group settings or by direct mail. Participants were queried for living status, social support, frequency of social activity, sociodemographic and lifestyle factors, and health conditions. Social isolation was assessed by lack of social support and decreased frequency of social activity. Physical activity (PA) was measured via an accelerometer and global positioning system (GPS), which was worn by the participant, for at least 7 consecutive days.
    Results Participants living alone (N = 110) had less social support than those living with others (N = 290) (p < 0.001) but did not differ significantly in the frequency of their social activities. Group-setting recruitment was strongly associated with greater social activity (p < 0.001). Less social support was independently associated with a less-than-high-school education (p = 0.001), higher CES-D depression score (p < 0.001) and lower PA (p = 0.003). Less social activity was independently associated with a less-than-high-school education (p = 0.007) and annual income less than $50,000 (p = 0.01).
    Discussion Older adults who are socioeconomically disadvantaged, have less social support, and who live alone are more likely to be socially isolated and may benefit from continuation of low-cost social activities and increased social support inside the home. Identifying correlates of social isolation may inform future interventions.

    Citation: Elizabeth Chan, Elizabeth Procter-Gray, Linda Churchill, Jie Cheng, Rachel Siden, Annabella Aguirre, Wenjun Li. Associations among living alone, social support and social activity in older adults[J]. AIMS Public Health, 2020, 7(3): 521-534. doi: 10.3934/publichealth.2020042

    Related Papers:

  • Objectives We examined cross-sectional associations of living alone with social isolation among community-dwelling older adults in Worcester County, Massachusetts, USA.
    Methods Four hundred participants 65 years old and older were recruited in community group settings or by direct mail. Participants were queried for living status, social support, frequency of social activity, sociodemographic and lifestyle factors, and health conditions. Social isolation was assessed by lack of social support and decreased frequency of social activity. Physical activity (PA) was measured via an accelerometer and global positioning system (GPS), which was worn by the participant, for at least 7 consecutive days.
    Results Participants living alone (N = 110) had less social support than those living with others (N = 290) (p < 0.001) but did not differ significantly in the frequency of their social activities. Group-setting recruitment was strongly associated with greater social activity (p < 0.001). Less social support was independently associated with a less-than-high-school education (p = 0.001), higher CES-D depression score (p < 0.001) and lower PA (p = 0.003). Less social activity was independently associated with a less-than-high-school education (p = 0.007) and annual income less than $50,000 (p = 0.01).
    Discussion Older adults who are socioeconomically disadvantaged, have less social support, and who live alone are more likely to be socially isolated and may benefit from continuation of low-cost social activities and increased social support inside the home. Identifying correlates of social isolation may inform future interventions.


    加载中

    Acknowledgments


    The authors thank the investigators, staff, and participants for their dedication and making this study possible. Dr. Wenjun Li conceived the study, obtained the funding, and guided the analysis. Drs. Wenjun Li, Marian Hannan, Sarah Berry and Scott Crouter are PI or co-investigators of the project and provided project oversight. We thank the research coordinators, statisticians, and data entry staff who implemented and participated in the study thus far. Linda Churchill was responsible for project management and IRB submissions. Linda Churchill, Annabella Aguirre, Rachel Siden and Elizabeth Chan recruited and followed participants. Kevin Kane was responsible for database management. Anthony Clarke and Jie Cheng processed accelerometer and GPS data. Dr. Procter-Gray conducted the statistical analysis. Elizabeth Chan and Dr. Procter-Gray drafted the manuscript. All authors contributed to the revision, read and approved the manuscript.

    Funding


    This research was supported in part by the National Institute on Aging, National Institutes of Health (2R56AGO28738-05A1; PI: Li). Data used from 2012–2014 was supported by a Life Science Moment Fund Award (PI: Li) of the University of Massachusetts Center for Clinical and Translational Sciences which is funded by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR000161 and the NIH-funded Women's Health Initiative (HHSN268201100001C). The content of the paper is solely the responsibility of the authors and does not necessarily represent the official views of NIA, NIH.

    Conflict of interest


    All authors declare no conflicts of interest in this paper.

    [1] Roberts AW, Ogunwole SU, Blakeslee L, et al. (2018)  The population 65 years and older in the United States: 2016: US Department of Commerce, Economics and Statistics Administration, US. Available from: https://www.census.gov/content/dam/Census/library/publications/2018/acs/ACS-38.pdf.
    [2] Teguo MT, Simo-Tabue N, Stoykova R, et al. (2016) Feelings of loneliness and living alone as predictors of mortality in the elderly: the PAQUID study. Psychosom Med 78: 904-909. doi: 10.1097/PSY.0000000000000386
    [3] Steptoe A, Shankar A, Demakakos P, et al. (2013) Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci 110: 5797-5801. doi: 10.1073/pnas.1219686110
    [4] Nicholson NR (2009) Social isolation in older adults: an evolutionary concept analysis. J Adv Nurs 65: 1342-1352. doi: 10.1111/j.1365-2648.2008.04959.x
    [5] Finlay JM, Kobayashi LC (2018) Social isolation and loneliness in later life: A parallel convergent mixed-methods case study of older adults and their residential contexts in the Minneapolis metropolitan area, USA. Soc Sci Med 208: 25-33. doi: 10.1016/j.socscimed.2018.05.010
    [6] Barth J, Schneider S, Von Känel R (2010) Lack of social support in the etiology and the prognosis of coronary heart disease: a systematic review and meta-analysis. Psychosom Med 72: 229-238. doi: 10.1097/PSY.0b013e3181d01611
    [7] Bassuk SS, Glass TA, Berkman LF (1999) Social disengagement and incident cognitive decline in community-dwelling elderly persons. Ann Intern Med 131: 165-173. doi: 10.7326/0003-4819-131-3-199908030-00002
    [8] Kiecolt-Glaser JK, Glaser R (2001) Stress and immunity: Age enhances the risks. Curr Dir Psychol Sci 10: 18-21. doi: 10.1111/1467-8721.00105
    [9] Hawton A, Green C, Dickens AP, et al. (2011) The impact of social isolation on the health status and health-related quality of life of older people. Qual Life Res 20: 57-67. doi: 10.1007/s11136-010-9717-2
    [10] Iliffe S, Kharicha K, Harari D, et al. (2007) Health risk appraisal in older people 2: the implications for clinicians and commissioners of social isolation risk in older people. Br J Gen Pract 57: 277-282. doi: 10.3399/096016407782604785
    [11] Elder K, Retrum J (2012)  Framework for isolation in adults over 50: AARP Foundation/isolation Framework Project San Diego CA: Research Works.
    [12] Iliffe S, Tai SS, Haines A, et al. (1992) Are elderly people living alone an at risk group? BMJ 305: 1001-1004. doi: 10.1136/bmj.305.6860.1001
    [13] Ennis SK, Larson EB, Grothaus L, et al. (2014) Association of living alone and hospitalization among community-dwelling elders with and without dementia. J Gen Intern Med 29: 1451-1459. doi: 10.1007/s11606-014-2904-z
    [14] Haslbeck JW, McCorkle R, Schaeffer D (2012) Chronic illness self-management while living alone in later life: a systematic integrative review. Res Aging 34: 507-547. doi: 10.1177/0164027511429808
    [15] Chakravarthy MV, Joyner MJ, Booth FW (2002) An obligation for primary care physicians to prescribe physical activity to sedentary patients to reduce the risk of chronic health conditions. Elsevier 165-173.
    [16] Glass TA, De Leon CM, Marottoli RA, et al. (1999) Population based study of social and productive activities as predictors of survival among elderly Americans. BMJ 319: 478-483. doi: 10.1136/bmj.319.7208.478
    [17] Greaves CJ, Farbus L (2006) Effects of creative and social activity on the health and well-being of socially isolated older people: outcomes from a multi-method observational study. J R Soc Promot Health 126: 134-142. doi: 10.1177/1466424006064303
    [18] Pfeiffer E (1975) A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 23: 433-441. doi: 10.1111/j.1532-5415.1975.tb00927.x
    [19] Katz S, Downs TD, Cash HR, et al. (1970) Progress in development of the index of ADL. Gerontologist 10: 20-30. doi: 10.1093/geront/10.1_Part_1.20
    [20] Radloff LS (1977) The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1: 385-401. doi: 10.1177/014662167700100306
    [21] Beck AT, Epstein N, Brown G, et al. (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56: 893-897. doi: 10.1037/0022-006X.56.6.893
    [22] Watt RG, Heilmann A, Sabbah W, et al. (2014) Social relationships and health related behaviors among older US adults. BMC Public Health 14: 533. doi: 10.1186/1471-2458-14-533
    [23] Smith GL, Banting L, Eime R, et al. (2017) The association between social support and physical activity in older adults: a systematic review. Int J Behav Nutr Phys Act 14: 56. doi: 10.1186/s12966-017-0509-8
    [24] Roh HW, Hong CH, Lee Y, et al. (2015) Participation in physical, social, and religious activity and risk of depression in the elderly: a community-based three-year longitudinal study in Korea. PloS One 10: e0132838. doi: 10.1371/journal.pone.0132838
    [25] George LK, Blazer DG, Hughes DC, et al. (1989) Social support and the outcome of major depression. Br J Psychiatry 154: 478-485. doi: 10.1192/bjp.154.4.478
    [26] Alexandrinosilva C, Alves TF, Tófoli LF, et al. (2011) Psychiatry: life events and social support in late life depression. Clinics 66: 233-238. doi: 10.1590/S1807-59322011000200009
    [27] Steger MF, Kashdan TB (2009) Depression and everyday social activity, belonging, and well-being. J Couns Psychol 56: 289-300. doi: 10.1037/a0015416
    [28] Mirowsky J, Ross CE (2005) Education, learned effectiveness and health. London Rev Edu 3: 205-220.
    [29] Shankar A, Hamer M, McMunn A, et al. (2013) Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing. Psychosom Med 75: 161-170. doi: 10.1097/PSY.0b013e31827f09cd
    [30] Jang SN, Choi YJ, Kim DH (2009) Association of socioeconomic status with successful ageing: differences in the components of successful ageing. J Biosocial Sci 41: 207-219. doi: 10.1017/S0021932008003052
    [31] Finkel D, Andel R, Pedersen NL (2016) Gender differences in longitudinal trajectories of change in physical, social, and cognitive/sedentary leisure activities. J Gerontol: Series B 73: 1491-1500. doi: 10.1093/geronb/gbw116
  • Reader Comments
  • © 2020 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索
AIMS Public Health
3.1 4.8

Metrics

Article views(4976) PDF downloads(307) Cited by(27)

Preview PDF
Download XML
Export Citation
Article outline

Figures and Tables

Tables(3)

Other Articles By Authors

Related pages

Tools

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog