New research highlights increased loneliness in over-70s during COVID-19 pandemic
July 15, 2020
Science Daily/Trinity College Dublin
A joint report published by researchers at the Irish Longitudinal Study on Ageing (TILDA) and ALONE examines issues of loneliness and social isolation in older adults. The report offers fresh insight into the experiences of those over 70 who were advised to 'cocoon' as part of public health measures to curtail the spread of the COVID-19 virus. New data from ALONE which documents increased feelings of loneliness, anxiety and isolation in older adults throughout the pandemic, is compared with experiences of loneliness and isolation in older adults before the COVID-19 outbreak.
Previous research into this area has shown that strong social ties may protect people from emotional distress, cognitive decline, and physical disability, while loneliness and social isolation can cause harm to physical and psychological wellbeing. Both loneliness and social isolation have been strongly associated with poorer quality of life and other measures of well-being.
The TILDA study offers unique insights into the health, habits and experiences of older adults living in Ireland through its longitudinal research, examining a variety of key areas that affect older adults such as physical and mental health as well as economic and social factors. Research from TILDA highlights the prevalence of loneliness and social isolation in its nationally representative survey of participants which gives clear insight into the experiences of older people.
What does TILDA's research show prior to the pandemic?
Over 70% of TILDA participants reported that they never or rarely feel lonely; less than 25% feel lonely some of the time while just 5% reported feeling lonely often.
Of those living alone, 31% are rarely lonely, 32% sometimes lonely and 37% often lonely.
Of those living with others, 49% are least lonely, 30% sometimes and 21% often lonely.
Researchers point out that most older adults are not often lonely and appear quite resilient, while data from ALONE's helpline suggest that the COVID-19 pandemic has taken a toll on older people.
The rise of loneliness in a pandemic
Measures introduced to curb the spread of the COVID-19 virus, including physical distancing, and self-isolation particularly affected those over 70 who were 'cocooning'; disrupting daily routines and social interactions with friends and family. Following the outbreak of the virus, ALONE's Support and Telephone Befriending service continued remotely with volunteers calling and sending regular texts to older people with health and well-being tips and practical supports. Almost 500 smartphones were distributed to older adults with limited means of social interaction. Following an increase in calls for support, ALONE established a dedicated phoneline to provide help and services to vulnerable older adults who may have needed them. Report data from ALONE highlights increased feelings of loneliness and isolation amongst older people during the COVID-19 pandemic.
What does ALONE's research show?
The ALONE national support line has received 26,174 calls during the period: March 9th to July 5th, 2020.
55% of callers were from the over 70s, the cohort advised to 'cocoon'.
75% of callers to the helpline were living alone.
There has been an increase in callers who are putting off medical treatment or examination, including after falls.
ALONE has seen a rise in callers reporting negative emotions, including suicidal ideation during the pandemic.
Callers have most often requested support for their physical health, befriending, and emotional and mental health needs.
The data highlights that public health measures such as social distancing and cocooning to curb the spread of the virus has increased levels of loneliness and social isolation in older people. This may have a negative effect on the well-being of older adults and suggests that public policies should be developed to ensure that these issues are addressed. Researchers suspect that current physical distancing and social isolation measures will be most keenly felt by those who rely on community or church-based social participation and engagement.
A future research project led by TILDA in collaboration with ALONE will investigate and document the impact of the COVID-19 pandemic on the health and general well-being of older adults.
Professor Rose Anne Kenny, Principal Investigator of TILDA said:
''This collaborative report between ALONE and TILDA offers a unique perspective into how older adults have been affected by the COVID-19 pandemic. TILDA research shows that most older adults are not often lonely and highlights the resilience of older adults as they adapt to an ever-changing world. The world has witnessed how older adults have been disproportionately affected by the pandemic. ALONE's research provides front- line evidence that shows the true toll public health measures have had on older people with increased feelings of loneliness, anxiety and isolation. The impact of the pandemic is now being studied in the TILDA cohort and will be reported later this year. This will more precisely inform the impact of COVID-19 on loneliness and social isolation, and areas for policy intervention.''
Sean Moynihan, Chief Executive Officer of ALONE said:
''ALONE's coordinated National Response to the COVID-19 pandemic allowed us to respond with immediacy to the concerns newly emerging, and existing issues being elevated from older people. We worked to keep all our services operative through adaptation of their structures. The presence of this virus in society has further solidified existing issues while further alienating some older people, as we have seen extensive increases in loneliness through the isolation experienced from cocooning. We established a loneliness taskforce to ensure we were putting provisions in place to safeguard older people, presently, and into the future. Society needs to understand that loneliness can happen to anyone and can damage both your physical and mental health. It is distressing and we want to work towards breaking down this stigma. As Ireland's ageing population continues to develop, we must remember that there are several thousands of older people behind every percentage."
https://www.sciencedaily.com/releases/2020/07/200715111451.htm
AAN recommends people 65+ be screened yearly for memory problems
September 19, 2019
Science Daily/American Academy of Neurology
To help physicians provide the highest quality patient-centered neurologic care, the American Academy of Neurology (AAN) is recommending physicians measure how frequently they complete annual assessments of people age 65 and older for thinking and memory problems.
People with mild cognitive impairment have thinking and memory problems but usually do not know it because such problems are not severe enough to affect their daily activities. Yet mild cognitive impairment can be an early sign of Alzheimer's disease or other forms of dementia. It can also be a symptom of sleep problems, medical illness, depression, or a side effect of medications.
To help physicians provide the highest quality patient-centered neurologic care, the American Academy of Neurology (AAN) is recommending physicians measure how frequently they complete annual assessments of people age 65 and older for thinking and memory problems. This metric for yearly cognitive screening tests is part of an AAN quality measurement set published in the September 18, 2019, online issue of Neurology®, the medical journal of the American Academy of Neurology.
A quality measure is a mathematical tool to help physicians and practices understand how often health care services are consistent with current best practices and are based on existing AAN guideline recommendations. Quality measures are intended to drive quality improvement in practice. Physicians are encouraged to start small using one or two quality measures in practice that are meaningful for their patient population, and measure use is voluntary.
"Since thinking skills are the most sensitive indicator of brain function and they can be tested cost-effectively, this creates an enormous opportunity to improve neurologic care," said author Norman L. Foster, MD, of the University of Utah in Salt Lake City and a Fellow of the American Academy of Neurology. "The American Academy of Neurology is recommending the measurement of annual cognitive screenings for everyone age 65 and older because age itself is a significant risk factor for cognitive decline and mild cognitive impairment is increasingly prevalent with older age. The measure complements past American Academy of Neurology quality measures released for Parkinson's disease, multiple sclerosis and stroke, and allows for a doctor to meet the measure with a recommended periodic three-minute cognitive test."
According to the 2018 AAN guideline on mild cognitive impairment, nearly 7 percent of people in their early 60s worldwide have mild cognitive impairment, while 38 percent of people age 85 and older have it.
The new AAN quality measurement set recommends doctors measure how often they conduct annual screenings to improve the recognition of mild cognitive impairment and allow for earlier intervention.
"We cannot expect people to report their own memory and thinking problems because they may not recognize that they are having problems or they may not share them with their doctors," said Foster. "Annual assessments will not only help identify mild cognitive impairment early, it will also help physicians more closely monitor possible worsening of the condition."
The new measurement set states that documenting mild cognitive impairment in a person's medical record can be invaluable in alerting other physicians and medical staff so that the best care is provided to that patient.
Early diagnosis can help identify forms of mild cognitive impairment that may be reversible, including those caused by sleep problems, depression or medications, and lead to treatments that can improve a person's quality of life such as correcting hearing loss and avoiding social isolation.
When mild cognitive impairment is not reversible and could develop into more severe forms of dementia like Alzheimer's disease, the quality measurement set recommends measuring how frequently people are given information about their condition as early as possible, so they can take steps to avoid exploitation, plan for their care and monitor their condition.
It is also important not to forget about family and caregivers. The measurement set also asks doctors to identify care partners to help describe symptoms. Doctors should quantify involvement with family and caregivers and provide them with information so that they too receive support and get access to services to help them cope if person's illness progresses and to improve their well-being.
https://www.sciencedaily.com/releases/2019/09/190919093916.htm
Osteoarthritis can increase your risk for social isolation
Research summary from the Journal of the American Geriatrics Society
October 15, 2019
Science Daily/American Geriatrics Society
Researchers examined whether there is an association between arthritis and social isolation, and have identified the disease's contribution to social isolation.
When older adults become lonely -- a condition health professionals call "social isolation" -- their health and well-being can suffer. In fact, there may be a link between being socially isolated and osteoarthritis (arthritis) which causes joint pain and can limit your ability to get around.
People who have arthritis often have other health issues which may increase their risk of becoming socially isolated. These include anxiety and depression, being afraid to move around (because arthritis makes moving painful), physical inactivity, and being unable to take care of themselves.
Some 30 percent of adults aged 65 and older have arthritis to some degree, especially in their leg joints. Despite that, until now there has been little research on the relationship between arthritis and social isolation.
In a study published in the Journal of the American Geriatrics Society, researchers examined information from the European Project on OSteoArthritis (EPOSA) study. They wanted to learn whether there is an association between arthritis and social isolation, and to identify the disease's contribution to social isolation.
EPOSA is a study of 2,942 adults between the ages of 65 to 85 years old who live in six European countries -- Germany, Italy, the Netherlands, Spain, Sweden, and the UK. In all, 1,967 people, around the age of 73, participated.
The researchers wanted to know whether the participants were socially isolated at the beginning of the study as well as 12 to 18 months later. To do so, the researchers used questionnaires that logged how often and how many times the participants connected socially with friends and family members. They also learned how often the participants volunteered or participated in social activities.
Half the participants were women, and almost 30 percent had arthritis. At the start of the study, almost 20 percent of the participants were socially isolated. Those who weren't socially isolated tended to be younger, had higher incomes and more education. They were also more likely to be physically active, had less physical pain, had faster walking times and were in better all-around health.
Of the 1,585 participants who weren't considered socially isolated at the beginning of the study, 13 percent had become socially isolated 12 to 18 months later. They reported that their health and osteoarthritis had worsened, they were in more pain, had become less physically active, had slower walking times, and had depression and problems with thinking and making decisions.
The researchers said that their study shows that osteoarthritis increases the risk of social isolation. Having problems with thinking and making decisions, as well as having slower walking times, is associated with an increased risk of becoming socially isolated, they said.
Because social isolation can worsen your health, the researchers suggested that older adults with arthritis perhaps could benefit from physical activity and participating in social activities. Specifically, they suggested, healthcare providers might refer people to senior centers where activities are specially designed for people with arthritis.
https://www.sciencedaily.com/releases/2019/10/191015171548.htm