OBJECTIVE: This study aimed to investigate the longitudinal relationship between social frailty and cognitive impairment among community-dwelling older adults.
METHODS: This retrospective cohort study is based on the first to eighth waves of the Korean Longitudinal Study of Ageing (2006-2020).
METHODS: The participants were 2106 community-dwelling older adults aged 65 years or older and without cognitive impairment in 2006.
METHODS: Social frailty was assessed with 5 items including social support, social activity, social network, loneliness, and living alone (0 = social nonfrailty, 1 = social prefrailty, 2 or more = social frailty). Cognitive function was assessed using the Korean Mini-Mental State Examination, and scores below 24 indicated cognitive impairment. We used the generalized estimating equation to assess the longitudinal relationship between social frailty and cognitive impairment.
RESULTS: Of the 2106 participants, 515 (24.4%) had social frailty, 669 (31.8%) had social prefrailty, and 922 (43.8%) were social nonfrailty based on the baseline assessments. Relative to the social nonfrailty group, the odds ratios of the social prefrailty and social frailty groups for cognitive impairment were 1.30 (95% CI 1.10-1.54) and 1.41 (95% CI 1.16-1.71), respectively, during the follow-up. Subgroup analysis showed that social inactivity and loneliness were significantly associated with cognitive impairment.
CONCLUSIONS: These findings highlight the need for health care providers to introduce and use available social resources for older adults with social frailty to increase the relationships between individual and social context. Social inactivity and loneliness were the major domains associated with cognitive impairment, and loneliness can be resolved by participating in social activities. Therefore, health care providers especially provide opportunities for social activities, such as group-based programs in the community, to reduce social frailty and cognitive impairment.

UNASSIGNED: Adolescence is a period in which mental health problems emerge. Research suggests that the COVID-19 lockdown may have worsened emotional and behavioral health.
UNASSIGNED: To examine whether socioeconomic status was associated with mental health outcomes among youths during the COVID-19 pandemic.
UNASSIGNED: The Adolescent Brain Cognitive Development (ABCD) Study is a multisite 10-year longitudinal study of youth neurocognitive development in the US. Recruitment was staggered where the baseline visit (ages 9 to 10 years) occurred from 2016 to 2018, and visits occurred yearly. The COVID-19 lockdown halted research collection during the 2-year follow-up visits (ages 11 to 12 years), but eventually resumed. As some youths already underwent their 2-year visits prior to lockdown, this allowed for a natural experiment-like design to compare prepandemic and intrapandemic groups. Thus, data were gathered from the 1-year follow-up (pre-COVID-19 lockdown for all youths) and the 2-year follow-up, of which a portion of youths had data collected after the lockdown began, to compare whether a period of near social isolation was associated with mental health symptoms in youths. The prepandemic group consisted of youths with a 2-year follow-up visit collected prior to March 11, 2020, and the intrapandemic group had their 2-year follow-up visit after lockdown restrictions were lifted.
UNASSIGNED: Assessments included measures on income-to-needs ratio (INR; derived from total household income), the Child Behavior Checklist (a measure of mental health symptomology), and the Family Environmental Scale.
UNASSIGNED: The final sample included 10 399 youths; 3947 (52.3%) were male; 2084 (20.3%) were Latinx/Hispanic; 6765 (66.0%) were White; 4600 (44.2%) reported caregiver education levels below a 4-year college degree; and 2475 (26.2%) had INR either below 100% (indicating poverty) or between 100% and less than 200% (near poverty). Among youths in the intrapandemic group, worse mental health symptoms (eg, more total problems, greater depression, and greater anxiety) over time were associated with being from a household with higher socioeconomic status (eg, when comparing individuals who differed by 1 unit on INR between prepandemic and intrapandemic groups from 1-year to 2-year follow-up, their expected difference in total problems score was 0.79 [95% CI, 0.37-1.22]; false discovery rate-corrected P < .001).
UNASSIGNED: This cohort study found that the COVID-19 lockdown was associated with disproportionately negative mental health outcomes among youths from higher socioeconomic status backgrounds. Although this study does not shed light on the direct mechanisms driving these associations, it does provide some support for positive outcomes for youths. Future studies are needed to understand whether these associations persist over longer periods of time.

Background Chronic conditions may limit older peoples\' social engagement and wellbeing. Reduced social connections can result in loneliness and social isolation. This study aimed to explore the experience of social connection in older people living with chronic conditions, and the factors influencing their social participation. Methods A purposive sample of 19 community-dwelling older Australians (mean age 75.5years) with one or more chronic conditions participated in a qualitative descriptive study. Semi-structured interviews explored participants\' perceptions of their social connections and the potential impact of their chronic conditions. Views about the role of general practice in supporting older persons\' wellbeing were discussed. Data were analysed inductively using thematic analysis. Results Five themes were identified: (1) the experience of loneliness, (2) managing diminishing social contacts, (3) living with chronic conditions, (4) barriers to social connection, and (5) facilitators of social connection. Participants felt that ageing with chronic conditions contributed to loss of function and independence, which limited social connections, and increased loneliness and social isolation. Barriers to social connections included issues with mobility, transport and forming new networks. Families were a primary support, with continued community engagement and general practice support crucial to staying well and socially connected. Conclusions Understanding older peoples\' experiences, and the barriers and facilitators of social connections can guide clinicians\' interventions. General practice is a promising intervention point because of its high use by those with chronic conditions to stay well. General practice nurses are well-placed to collaboratively address the barriers older people face in maintaining social connections.

BACKGROUND: With increasing trend of internet use in all age groups, whether internet use can prevent frailty in middle-aged and older adults remains unclear.
METHODS: Five cohorts, including Health and Retirement Study (HRS), China Health and Retirement Longitudinal Study (CHARLS), the Survey of Health, Ageing and Retirement in Europe (SHARE), English Longitudinal Study of Aging (ELSA), and Mexican Health and Aging Study (MHAS), were used in this study. Internet use, social isolation, and frailty status was assessed using similar questions. The Generalized estimating equations models, random effects meta-analysis, COX regression, and mediation analysis were utilized.
RESULTS: In the multicohort study, a total of 155,695 participants were included in main analysis. The proportion of internet use was varied across countries, ranging from 5.56% in China (CHARLS) to 83.46% in Denmark (SHARE). According to the generalized estimating equations models and meta-analysis, internet use was inversely associated with frailty, with the pooled ORs (95%CIs) of 0.72 (0.67,0.79). The COX regression also showed that participants with internet use had a lower risk of frailty incidence. Additionally, the association was partially mediated by social isolation and slightly pronounced in participants aged 65 and over, male, not working for payment, not married or partnered, not smoking, drinking, and not co-residence with children.
CONCLUSIONS: Our findings highlight the important role of internet use in preventing frailty and recommend more engagements in social communication and activities to avoid social isolation among middle-aged and older adults.

UNASSIGNED: Though a worldwide period of uncertainty (COVID-19) has \'ended\', there exists a legacy of maladaptive experiences among people with significant appearance concerns (SAC) that requires care and attention.
UNASSIGNED: Using Giddens\' concept of ontological security, we explored how people experienced their SAC before, during and \"since\" COVID-19. Qualitative surveys allowed us to capture diverse perspectives from individuals transnationally, analysed with deductive reflexive thematic analysis using ontological security as our theoretical foundation.
UNASSIGNED: Themes named \"More Mirror(ed) Time\" and \"Locked Out, Shut Down, and Shut Out\" gave a contextual grounding for the embodied experiences of this group through times of social restrictions, and the theme \"Redefining Relevance\" explored the continued legacy of COVID-19 - and continued global uncertainties such as economic hardship and warfare - that impact the wellbeing of people with SAC.
UNASSIGNED: People with SAC are still \'locked out\' from essential healthcare support as those providing healthcare are overworked, under-resourced and rely on efficient interactive methods such as tele-health that may be triggers for people with SAC. Care providers may consider expanding appearance concerns verbiage, look to involve trusted others in the care-seeking process, and utilize modalities beyond digital health to support people with SAC.

OBJECTIVE: Loneliness and social isolation are associated with adverse health outcomes, especially within the elderly population, underlining the need for effective interventions. This systematic review and meta-analysis aims to summarize all available evidence regarding the effectiveness of interventions for loneliness and social isolation, to map out their working mechanisms, and to give implications for policy and practice.
METHODS: Systematic literature review and meta-analysis.
METHODS: Older adults (≥65 years).
METHODS: A systematic search was conducted in MEDLINE, PsycINFO, and CINAHL for studies quantitively or qualitatively assessing effects of interventions for loneliness and social isolation in older adults, following predefined selection criteria. Risk of bias as well as small study effects were assessed and, wherever appropriate, information about effect sizes of individual studies pooled using random-effects meta-analyses. Sources for between-study heterogeneity were explored using meta-regression.
RESULTS: Of n = 2223 identified articles, n = 67 were eventually included for narrative synthesis. Significant intervention effects were reported for a proportion of studies (55.9% and 50.0% for loneliness and social isolation, respectively) and 57.6% of studies including a follow-up measure (n = 29) reported sustained intervention effects. Meta-analysis of n = 27 studies, representing n = 1756 participants, suggested a medium overall effect of loneliness interventions (d = -0.47; 95% CI, -0.62 to -0.32). Between-study heterogeneity was substantial and could not be explained by differences in study design, year of publication, outcome measures, intervention length, participant demographics, setting, baseline level of loneliness, or geographic location. However, non-technology-based interventions reported larger effect sizes on average (Δd = -0.35; 95% CI, -0.66 to -0.04; P = .029) and were more often significant. Qualitative assessment of potential intervention mechanisms resulted in 3 clusters of effective components: \"promoting social contact,\" \"transferring knowledge and skills,\" and \"addressing social cognition\".
CONCLUSIONS: Interventions for loneliness and social isolation can generally be effective, although some unexplained between-study heterogeneity remains. Further research is needed regarding the applicability of interventions across different settings and countries, also considering their cost-effectiveness.

Communication is considered as one of the basic human needs. For a long time, loneliness and social isolation were mainly considered as a psychosocial problem. However, in the recent years, there has been increasing evidence of the possible impact of loneliness and social isolation on the development and clinical course of somatic diseases. Research objectives were studying and analysis of current literature data about the medical consequences of loneliness and social isolation in the elderly cases. An analysis of the literature data shows that loneliness and social isolation affect not only the psycho-emotional status of elderly patients, but also their physical health. It has been shown that the number of available social connections affects the development and clinical course of diabetes mellitus, cardiovascular diseases, and outcomes of the brain stroke, immune system reactions, average life expectancy, and the risk of death caused by any causes. It has been established that the influence of social ties on the risk and clinical course of chronic non-communicable diseases is comparable to the effect of such generally accepted risk factors like smoking, alcohol consumption, physical inactivity, hypertension, obesity, hypercholesterolemia, environmental pollution, as well as various medical interventions (vaccination, drug therapy, etc.). Social isolation affects the risk of hospitalization and the frequency of outpatient care, poor socialization increases the risk of death from a heart attack. The results of the study show that loneliness and social isolation of the elderly cases have certain medical consequences that need to be taken into account when managing such patients.
Общение считается одной из базовых потребностей человека. Долгое время одиночество и социальная изоляция считались преимущественно психосоциальной проблемой. Однако в последние годы появляется все больше свидетельств о возможном влиянии одиночества и социальной изоляции на развитие и клиническое течение соматических заболеваний. Цель работы — изучение современных данных литературы о медицинских последствиях одиночества и социальной изоляции у лиц пожилого возраста. Анализ данных показал, что одиночество и социальная изоляция влияют не только на психоэмоциональный статус пожилых пациентов, но и на состояние физического здоровья. Показано, что количество имеющихся социальных связей влияет на развитие и течение сахарного диабета, болезней сердца и сосудов, исходы инсульта мозга, реакции иммунной системы, среднюю продолжительность жизни, риск смерти, вызванной любыми причинами. Установлено, что уменьшение объема социальных связей влияет на риск возникновения и течение хронических неинфекционных заболеваний, что сопоставимо с действием таких общепризнанных факторов риска, как курение, употребление алкогольных напитков, гиподинамия, артериальная гипертензия, ожирение, гиперхолестеринемия, загрязнение окружающей среды, а также различные медицинские вмешательства (вакцинация, медикаментозная терапия и т. п.). Социальная изоляция влияет на риск госпитализации и частоту обращений за амбулаторной помощью, плохая социализация увеличивает риск смерти от сердечного приступа. Результаты исследования показывают, что одиночество и социальная изоляция пожилых пациентов имеют определенные медицинские последствия, которые нужно учитывать при ведении данной категории лиц.

UNASSIGNED: Marital factor has been associated with dementia and Alzheimer\'s disease, but there is limited evidence on the impact of holistic marital history over time.
UNASSIGNED: This study aimed to examine association of marital history with cognition.
UNASSIGNED: The study included 24,596 dementia-free participants from the Chinese Longitudinal Healthy Longevity Study (CLHLS). Holistic marital history was collected at baseline, categorizing participants into five groups: widow-single, widow-remarried, divorce-single, divorce-remarried and married based on the first two marriages. Dementia was collected at follow-up through self-report or from a delegate if the participant was deceased. For 15,355 participants, the Chinese Mini-Mental Status Examination (CMMSE) was administered at both baseline and follow-ups. Cognitive impairment was defined as a follow-up CMMSE score below 18, and rate of cognitive change was calculated as the change in CMMSE score between consecutive visits divided by the duration.
UNASSIGNED: Compared with married older adults, widow-single group had significantly higher risk of dementia (HR 1.28, 95% CI 1.05, 1.54), cognitive impairment (HR 1.31, 95% CI 1.17, 1.47) and significantly faster decline of MMSE score (β -0.09, 95% CI -0.17, -0.01). Meanwhile, widow-remarried group had significantly lower risk of dementia, cognitive impairment and slower MMSE score decline than widow-single group, although the differences were only significant among female but not male.
UNASSIGNED: In this prospective cohort, married older adults and those widowed but with a second marriage had significantly better cognition than widowed individuals who did not remarry.

BACKGROUND: Social isolation and loneliness (SIL) worsens mortality and other outcomes among older adults as much as smoking. We previously tested the impact of the HOW R U? intervention using peer support from similar-aged volunteers and demonstrated reduced SIL among older adults discharged from the emergency department (ED). Generativity, defined as \"the interest in establishing and guiding the next generation,\" can provide an alternative theoretical basis for reducing SIL via intergenerational programs between members of younger and older generations. The current protocol will examine the impact of younger intergenerational volunteers providing the HOW RU?
METHODS:
METHODS: In this randomized clinical trial, we will compare the following three arms: (1) the standard same-generation peer support HOW R U? intervention, (2) HOW R U? intervention delivered by intergenerational volunteers, and (3) a common wait-list control group. Outcome assessors will be blinded to the intervention. Trained volunteers will deliver 12 weekly telephone support calls. We will recruit participants ≥ 70 years of age with baseline loneliness (six-item De Jong loneliness score of 2 or greater) from two EDs. Research staff will assess SIL, depression, quality of life, functional status, generativity, and perceived benefit at baseline, at 12 weeks, and 24 weeks post-intervention.
CONCLUSIONS: We hypothesize participants receiving the intergenerational intervention will show improved outcomes compared to the control group and peer support HOW R U?
METHODS: We also hypothesize that participants with higher perceptions of generativity will have greater reductions in SIL than their lower generativity counterparts. Aging is experienced diversely, and social interventions combatting associated SIL should reflect that diversity. As part of a program of research following the Obesity-Related Behavioral Intervention Trials (ORBIT) model, the findings of this RCT will be used to define which intervention characteristics are most effective in reducing SIL.
BACKGROUND: ClinicalTrials.gov NCT05998343 Protocol ID:21-0074E. Registered on 24 July 2023.

UNASSIGNED: Support for people with dementia in their communities is neither robust nor consistent in the UK, often bolstered by third sector/grass-roots initiatives facing formidable challenges in sustaining long-term. The Get Real with Meeting Centres project explored factors involved in sustaining one such form of community-based support. This is the second of two linked articles outlining learning from this realist evaluation of Meeting Centres (MCs) for people with dementia and carers, which focusses on findings regarding their operational and strategic running.
UNASSIGNED: Semi-structured interviews and focus group discussions were conducted with 77 participants across three MC sites in England and Wales, including people living with dementia, informal carers, staff, volunteers, trustees, and supporting professionals/practitioners. Data were themed, then analysed using soft systems methodology and realist logic of analysis.
UNASSIGNED: Forty-two \'context-mechanism-outcome\' statements were generated, explaining how background circumstances might trigger responses/processes to produce wanted or unwanted outcomes regarding three key areas for MC sustainability: External relationships and collaboration; Internal relationships and practices; and Finances and funding.
UNASSIGNED: Collaboration is essential to sustaining community-based initiatives such as MCs, particularly between local community and regional level. MCs need to be vigilant in mitigating pressures that create \'mission drift\', as targeting a gap in the care pathway and maintaining a person-centred ethos are central to MCs\' appeal. Stable, ongoing funding is needed for stable, ongoing community dementia support. More formal recognition of the value of social model community-based initiatives, helped by improved data collection, would encourage more robust and consistent community dementia support.