Social contacts and their relationship to loneliness among aged people - a population-based study

BACKGROUND: Emotional loneliness and social isolation are major problems in old age. These concepts are interrelated and often used interchangeably, but few studies have investigated them simultaneously thus trying to clarify their relationship. OBJECTIVES: To describe the prevalence of loneliness among aged Finns and to study the relationship of loneliness with the frequency of social contacts, with older people's expectations and satisfaction of their human relationships. Especially, we wanted to clarify whether emotional loneliness is a separate concept from social isolation. METHODS: The data were collected with a postal questionnaire. Background information, feelings of loneliness, number of friends, frequency of contacts with children, grandchildren and friends, the expectations of frequency of contacts as well as satisfaction of the contacts were inquired. The questionnaire was sent to a random sample of 6,786 aged people (>74 years) in various urban and rural areas in Finland. We report here the results of community-dwelling respondents (n = 4,113). MAIN RESULTS: More than one third of the respondents (39.4%) suffered from loneliness. Feeling of loneliness was not associated with the frequency of contacts with children and friends but rather with expectations and satisfaction of these contacts. The most powerful predictors of loneliness were living alone, depression, experienced poor understanding by the nearest, and unfulfilled expectations of contacts with friends. CONCLUSION: Our findings support the view that emotional loneliness is a separate concept from social isolation. This has implications for practice. Interventions aiming at relieving loneliness should be focused on enabling an individual to reflect her own expectations and inner feelings of loneliness.     

Buddhism and emotional support for elderly people

This paper discusses the important religious role of elderly people in traditional Khmer society and traces the construction of new lives by refugees to Western countries in the past decade, showing the important place of monasteries as a focus for the old. The data derive from field work in Cambodia in 1965–66 and from several shorter periods of fieldwork in the mid-1980s among Cambodian refugees in France, Thailand, Australia, Germany and the United States.     

Social support and depression among elderly Chinese people in Hong Kong.

This study examines the association between social support and depressive symptomatology in a representative community sample of 1106 Chinese people in Hong Kong aged sixty years or older. Significant bivariate relationships were found between depression and all dimensions of social support including social network size, network composition, social contact frequency, satisfaction of social support, instrumental/emotional support, and helping others. Using multiple regression models, the authors found that at least one measure of these six dimensions of social support was associated with depressive symptomatology, even after controlling for socio-demographic, and functional disability. We found that social support from family is important for elderly Chinese people in Hong Kong, and satisfaction with support is a more important predictor of depression levels than other objective measures of network relationships. Lastly, it was found that material aid and instrumental support is more important in preventing depression for elderly individuals in Hong Kong than emotional support.     

Validity and reliability of auditory screening tests in demented and non-demented older adults

The validity and reliability of auditory screening tests were evaluated in 34 demented and 31 non-demented elderly outpatients. In reference to an audiometric gold standard (40-dB HL hearing loss in speech frequencies), 512-Hz and 1024-Hz tuning forks, finger rub, and whispered voice tests performed well (ROC curve areas = 0.82 to 0.94). Simultaneously high (greater than 0.80) sensitivities and specificities were achievable for all these tests in demented patients. In non-demented patients, however, only the whispered voice test achieved simultaneously high specificity and sensitivity. The most accurate rule for air conduction screening audiometry was the inability to hear greater than or equal to two of four 40-dB HL speech frequencies (sensitivity = 1.0, specificity = 0.75 in non-demented patients; sensitivity = 0.97, specificity = 0.74 in demented patients). Interobserver/test-retest reliability was generally high for tuning forks, finger rub, and whispered voice tests (range of intraclass correlation coefficients = 0.38 to 0.90), and was somewhat higher in demented than in non-demented patients. These results suggest that some of the simple, traditional methods of auditory screening may have considerable validity and reliability in demented and non-demented older adults.     

Social networks, institutionalization, and mortality among elderly people in the United States.

This study focuses on the effect of social networks on institutionalization and mortality among elderly people in the United States. Data are from the Longitudinal Study of Aging (LSOA), which incorporates a baseline interview in 1984 and a follow-up interview two years later. The study population consists of a sample of 5,151 noninstitutionalized elderly people who were 70 years of age or older in 1984. Multivariate analyses using logistic regression revealed that social networks are negatively related to the likelihood of institutionalization and mortality when controlling for sociodemographic characteristics and baseline health status. Elderly people who participated in some form of social activity decreased their risk of institutionalization by almost one-half, whereas living alone increased the likelihood of institutionalization. Participating in social activities and visiting or talking with friends or relatives was negatively related to the likelihood of mortality.     

The demographics of loneliness among older people in Perth,Western Australia

Objectives: To determine the prevalence and demographic correlates of loneliness in a sample of older people in Perth, Western Australia. Methods: People aged 65 years and over living in private dwellings were recruited randomly, stratified by socioeconomic area, sex and 5‐year age groups to 85 years. A total of 353 people with mean age of 77.5 years responded to a mailed questionnaire comprising demographic questions and three measures of loneliness. Results: Severe loneliness was reported by 7.0% of the sample and feeling lonely sometimes by 31.5%. Higher levels of loneliness were reported by single participants, those who lived alone and those with worse self‐rated health. The protective value against loneliness of social networks appears to be, in order of importance: friends, relatives, neighbours and children. Conclusions: Although loneliness is not universally reported by older Perth residents, its prevalence is still considerable and worthy of attention from mental health practitioners and policy‐makers.     

APOE polymorphism affects episodic memory among non demented elderly subjects

The APOE ε4 allele has been associated with a number of neurodegenerative disorders e.g. Alzheimer’s disease. Inconsistent results have been obtained for cognitive decline in ‘normal’ aging. We investigated whether specific aspects of cognitive decline were associated with APOE ε4 among 620 ‘healthy’ elderly subjects living in Calabria, southern Italy. MMSE scores ranged from 11 to 30. A lower MMSE score was unrelated to APOE polymorphism, i.e. a global measure of cognition. However, poorer episodic memory was associated with APOE ε4, both registration (p = 0.01) and recall (p = 0.01). Temporal and spatial orientation, attention and calculation, language, and constructive function were not affected. We conclude that episodic memory, specifically, is adversely affected by APOE ε4 and urge evaluation of precise phenotypes in genetic association studies of cognitive decline in order to avoid inconsistent results due to phenotypic heterogeneity.     

The effect of loneliness and change in loneliness on self-rated health (SRH): a longitudinal study among aging people

The association between adverse health and loneliness among aging people is known, but most of the studies are cross-sectional. In addition, the associations between changes in loneliness with health are less well known, especially in the case of aging people. The present study examined whether absence of loneliness in 2005 predicted subsequent good SRH in 2008, and whether changes in loneliness were associated with SRH in 2008. Longitudinal, questionnaire-based data were collected from three age cohorts (born in 1926-30, 1936-40, and 1946-50) living in southern Finland. Baseline data was collected in 2002 (n = 2815, 66%); the follow-ups were done in 2005 (n = 2476, 60%) and 2008 (n = 2064, 73%). Logistic regression analyses were used to derive the results. Never or seldom experiencing loneliness was a strong predictor for good SRH. In addition, good health was common among those who never felt lonely. Among men the group experiencing decreasing loneliness had the highest OR of good health. Thus, loneliness is a significant contributor to poor SRH among aging people. In addition, favorable SRH is indicated not only by the absence of loneliness at both measurement points, but also by decreased loneliness. Preventing loneliness is important for health promotion.     

Epidemiology of falls among community-dwelling elderly people

The purpose of the present study was to report the prevalence and circumstances of falls among community-dwelling elderly people in order to contribute to prevention of falls in the community. The subjects were 2,774 elderly people who participated in health examinations conducted by Tokoname-shi, Aichi Prefecture in 2002. The variables investigated in the present study were demography and history of falls in the past one-year. Circumstances of falls, e.g. time, location, activities associated with falls, cause of falls and degree of injury due to falls were asked when the subjects experienced a fall. The prevalence of falls among 2,774 subjects was 13.7%. It was significantly higher among women (17.2%) than men (8.3%, chi 2 = 48.1, p < 0.001). Prevalence increased as subjects get older. Circumstances of falls were assessed in 655 subjects. The distribution of time, location, activity associated with falls, cause and injury due to falls corresponded with previous fall studies among community dwelling elderly people. The incidence of falls was extremely high during the daytime and outdoors. Falls occurred most frequently while walking. The majority of falls were due to extrinsic factors. About 10% of all falls caused fracture.     

Social relations and exclusion among people facing death

In line with current policies and service developments related to palliative care, more people are dying at home. This situation has provoked discussions about the importance of non-medical issues related to death. The process of dying is often long, with many phases, and the social aspect is a major part of it. Our focus in this article is on dying as a social process. Social relationships are significant and play a meaningful role in enhancing the well-being of older adults approaching the end of life. Meaningful social relationships tend to change over time; however, and the process of dying may exacerbate such changes in and challenge these relationships. The aim of our study was to examine how social relationships are experienced and (re)constructed among older adults (70–83 years old) during the process of dying, in a Finnish context. We were interested in the nature and type of these relationships, and in the possible new forms of expression that may emerge during this process. Our empirical data were based on interviews with seven older adults who were close to death. The analysis revealed processes of exclusion from existing relations. At the same time, we observed new and unexpected relations being initiated, which sometimes became meaningful and supportive. The results highlighted the role of expectations and importance of analysing exclusion from a life-course perspective.     

Angina among elderly people and its relationship with disability

A postal questionnaire was sent to 2705 people aged 60 and over requesting information about anginal symptoms, their degree of disability and dependency and the use they made of community services. Those with angina showed marked degrees of disability and dependency and used some services to a considerable extent. Postal questionnaires are a satisfactory screening device for identifying individuals at risk and can assist practitioners in organizing their workload for patients with disabling conditions.     

Urinary incontinence among the elderly people of Singapore

In a sample of 919 respondents aged 65 years and older, resident in a public housing estate in Singapore, the prevalence of regular urinary incontinence was 4.6%. Thirty-five of the 42 incontinent subjects consented to a detailed interview. The majority of these 35 cases leaked urine daily, leaked amounts over one tablespoon, or were suffering some psychological [corrected] or social effect of the incontinence. Urge incontinence was the commonest type in women and outlet obstruction in men. Almost all incontinent subjects were agreeable to having medical attention for the condition although over a third had not previously consulted medical personnel about the problem. There may be scope for the provision of primary health care continence services.