Addressing unmet mental health needs of older adults in Turbo, Colombia: a multi-component psychosocial intervention feasibility study.

BACKGROUND: Older adults have lived through extreme and stressful live events in Colombia, including during the armed conflict. Without adequate mental health resources in place, the aim of this study was to feasibility test a co-produced community-integrated intervention for older adults to improve their mental health and well-being in Turbo, Colombia. METHODS: Based on a systematic review and meta-analysis of community-based mental health interventions for older adults in LMICs, qualitative interviews with older adults and local stakeholders, as well as a mental health needs assessment survey of the local older adult population in Turbo, Colombia, we consulted older adults in the region to co-produce a community-based intervention. The co-produced intervention ran for three months in 2023, with two sessions provided per week in a community centre (26 sessions in total). The multi-component intervention included social engagement, educational interventions, physical activities, and peer support. Older adults were recruited from the local community. Twelve participants were interviewed about their experiences of the intervention and its feasibility. RESULTS: Eighteen older adults participated in the intervention, with 13 completing the 12 weeks. Attendance rate was high, with 10 participants attending between 90 to 100% of all 26 sessions. Qualitative interviews with 12 participants showed that participants valued the intervention and the activities it offered, that the intervention was feasible, and expressed a keen interest for the intervention to be continued. CONCLUSIONS: This co-produced and evidence-based intervention for older victims of 'La Violencia' in Colombia has the potential to provide affordable, acceptable and relevant community-based resources supporting mental health and wellbeing within the community; providing care and support with trained facilitation. Normally, this group would not be able to access services to address their social and psychological isolation and distress. In light of limited mental health support across LMICs, this intervention could provide mental health for older adults in other communities in Colombia and elsewhere developed through co-production, cultural adaptation, subject to further evaluation.

Peruvian Adolescent Mental Health Across Two Years of the COVID-19 Pandemic: A Four Time-Point Longitudinal Study.

PURPOSE: This study investigated symptoms of anxiety and depression, feelings of loneliness, and life satisfaction among low-to-middle income Peruvian adolescents during 2 years of remote schooling due to the COVID-19 lockdown. METHODS: We used a four-wave longitudinal observational approach. Data were collected in April 2020, October 2020, June 2021, and November 2021 in Perú. A total of 2,392 adolescents (ages 10-15; 57% female) participated in the study. We described longitudinal changes in symptoms of anxiety and depression, feelings of loneliness, and life satisfaction across the four time points and investigated sex and school grade differences. RESULTS: Symptoms of anxiety, depression, and loneliness increased, and life satisfaction decreased over the course of 2 years of remote education. The rate of change was different for each outcome of well-being. We found robust sex differences for all outcomes. In addition, we found school grade differences for anxiety and depression. DISCUSSION: The mental health and well-being of Peruvian adolescents, particularly female adolescents, declined during 2 years of remote education, despite loosening of other pandemic restrictions. Depression appears to have the earliest impacts, with anxiety levels showing even some improvement for male adolescents. School grade differences in levels of anxiety and depression for seventh and eighth graders in 2020 and 2021 provide initial evidence to disentangle pandemic from developmental effects.

Factors associated with the perception of resentment towards the Chinese in Latin America during the first wave of the COVID-19 pandemic.

INTRODUCTION: Resentment towards the Chinese population was perceived during the first months of the pandemic because the pandemic/disease started in that country. OBJECTIVE: To determine the factors associated with the perception of resentment towards the Chinese in Latin America during the first wave of the COVID-19 pandemic. METHODOLOGY: Analytical cross-sectional study conducted during the second semester of the pandemic in more than a dozen countries. Four questions were asked about the perception of resentment towards the Chinese (Cronbach's Alpha: 0.88); those with the highest scores on the sum of the four questions were considered to have "more resentment towards the Chinese," and descriptive and analytical statistics were obtained. RESULTS: Of the 7721 respondents, in the multivariate analysis, it was found that there was a difference according to the country; compared to Peru, those who had more resentment towards the Chinese were those residing in Paraguay (aPR: 1.29; 95%CI: 1.17-1.42; p-value < 0.001) and Bolivia (aPR: 1.52; 95%CI: 1.37-1.68; p-value < 0.001), while Chile (aPR: 0.78; 95%CI: 0.69-0.88; p-value < 0.001) had less resentment: 0.69-0.88; p-value < 0.001), Mexico (aPR: 0.68; 95%CI: 0.57-0.80; p-value < 0.001), Panama (aPR: 0.71; 95%CI: 0.59-0.86; p-value < 0.001) and Costa Rica (aPR: 0.64; 95%CI: 0.49-0.85; p-value = 0.002). DISCUSSION: There was a significant difference in resentment for each country.

Clinical and lifestyle predictors of loneliness: A two-year longitudinal study.

BACKGROUND: While loneliness is a global public health problem, the literature lacks studies assessing loneliness predictors in low- and middle-income countries. Therefore, we aimed to analyze clinical and lifestyle predictors of loneliness. METHODS: We conducted a 2-year longitudinal study in Brazil based on a snowball sample and online surveys (baseline: May 6 to June 6, 2020). We assessed clinical and lifestyle predictors of loneliness using multiple regression models. The analyses were adjusted for several sociodemographic variables and weighted for attrition and sampling procedures. RESULTS: The study included a nationwide sample of 473 participants (18-75 years; 87.1% females). After adjusting for sociodemographic factors, we identified as risk factors: depressive symptoms (RR: 1.214; 95%CI: 1.08-1.36; p = 0.001), anxiety symptoms (RR:1.191; 95%CI: 1.04-1.35; p = 0.007), alcohol abuse (RR: 1.579; 95%CI: 1.32-1.88; p < 0.001), and cannabis use (RR: 1.750; 95%CI: 1.25-2.39; p < 0.001). More than 150 min/week of physical activity (RR: 0.177; 95%CI: 0.07-0.34; p < 0.001) and good/excellent quality of family relationships (RR: 0.73; 95%CI: 0.60-0.87; p < 0.001) and sleep (RR: 0.483; 95%CI: 0.39-0.59; p < 0.001) were protective factors. CONCLUSION: Several clinical factors (depression, anxiety, alcohol, and cannabis) have been identified as risk factors for loneliness, while lifestyle factors (physical activity, better quality of sleep, and family relationships) have been associated with a lower incidence of loneliness. Addressing clinical and lifestyle factors may therefore be essential to preventing loneliness.

Family characteristics and loneliness among older adults: evidence from the Brazilian Longitudinal Study of Aging (ELSI-Brazil).

OBJECTIVE: To investigate the association between family characteristics concerning partners and children and loneliness among Brazilians aged 50 and over, taking into account both the occurrence of loneliness and its severity levels. METHODS: This cross-sectional study used data from 7,163 participants in the second wave of the Brazilian Longitudinal Study of Aging, a nationally representative study conducted in 2019-2021. Loneliness was assessed using the 3-item University of California Loneliness Scale. Family characteristics included: marital status and living with the partner and presence of children and living with them. Statistical analysis employed Zero-Inflated Negative Binomial regression models, allowing the assessment of the outcome in both dichotomous and counting-based forms. RESULTS: Only family characteristics related to the partner were associated with loneliness prevalence, whether in a living-apart-together arrangement (PR=0.35; 95%CI 0.23-0.53) or cohabiting (PR=0.37; 95%CI 0.30-0.45). Family characteristics concerning the partner [cohabiting (PR=0.80; 95% CI 0.73-0.88)] and children [non-cohabiting (PR=0.86; 95%CI 0.77-0.95) or cohabiting (PR=0.81; 95%CI 0.72-0,92)] were negatively associated with loneliness levels. CONCLUSION: Family characteristics play a crucial role in both preventing loneliness and reducing its levels. Public services for improving social support should target older adults with reduced nuclear families.

The role of meaning in life in the association between loneliness and depression: a mediation study among older adults from 26 European countries.

Loneliness and depression are serious public mental health problems. Meaning in life (MIL) is associated with reduced loneliness and depression. This study aimed to: (1) investigate associations between loneliness, MIL, and depression, differentiated by sex in individuals aged ≥ 50 years, residing in 26 European countries and Israel, and (2) to examine in men and women separately whether MIL mediated the relationship between loneliness and depression. We included 41,372 individuals (23,789 women) who responded to wave 8 of the SHARE project. The variables analyzed were loneliness (UCLA), depression (EURO-D scale), and MIL (CASP-19). The analytical procedures included regression analysis and exploratory mediation analysis. Among men and women, the odds of loneliness increasing depression were 3.6 and 3.3 times higher, respectively. Among men, feeling MIL sometimes or often had odds for reducing depression by 0.53 and 0.21, respectively. In women, feeling MIL sometimes or frequently reduced the odds of depression by 0.37 and 0.19, respectively. Regardless of sex, mediation analyses showed a positive association between loneliness and depression, while MIL was negatively associated with loneliness and depression. MIL partially mediated the association between LON and depression in male and female models by approximately 83.2% and 80.7%, respectively. No differences were found between men's and women's mediation models. Regardless of sex, high levels of MIL seem to be effective in benefiting the mental health of Europeans aged 50 and over. MIL proved to be a significant mediator of the relationship between loneliness and depression, while loneliness and depression strengthened each other.

Effects of Anxiety, Stress and Perceived Social Support on Depression and Loneliness Among Older People During the COVID-19 Pandemic: A Cross-Sectional Path Analysis.

During the COVID-19 pandemic, older people were exposed to high levels of anxiety and stress leading to loneliness and depressive disorders. The purpose of the present study was to investigate the effects of anxiety, positive coping, perceived social support, and perceived stress on depression and loneliness among older people during the COVID-19 pandemic. This was a cross-sectional online/telephone survey. A non-probability convenience sampling method was used. Participants were 112 people aged 60 years and above, without cognitive impairment, who experienced confinement (from March 2020 onward) and had access to the internet or telephone. A path analysis model showed a direct significant effect of anxiety on both, depression (ß = .68, P < .001) and perceived stress (ß = .65, P < .001), as well as an indirect effect of anxiety on loneliness via perceived stress (ß = .65) * (ß = .40); and social support (ß = -.21) * (ß = -.20). The model showed adequate fit χ2(df = 4) =5.972, P = .201; RMSEA = 0.066 (0.000, 0.169), CFI = 0.992; TLI = 0.970. Anxiety had a significant effect on depressive symptoms as well as on loneliness via perceived social support and perceived stress. According to our findings, in order to reduce depressive symptoms and perceived loneliness, it is essential to develop timely interventions that decrease levels of anxiety and stress and increase levels of perceived social support in older people, particularly when there are any restrictions, physical or contextual, that prevent face-to-face contact. This can be achieved by implementing preventive community-based programs, enhancing accessibility to mental health services, and collaborating with local support groups, among others.

The Role of Functional Deficits, Depression, and Cognitive Symptoms in the Perceived Loneliness of Older Adults in Mexico City.

The world is aging and experiencing loneliness. Functional impairment in instrumental activities of daily living (IADL) in older people (OP) with mild neurocognitive disorder (MNCD) predicts loneliness. After the pandemic, there was an increase in perceived loneliness. We explored the association between loneliness, depression, deficits in IADL, and cognitive symptoms among OP. From February to December 2023, using a cross-sectional design, we interviewed probable cases with mild cognitive impairment and caregivers in two public facilities. We administered the UCLA Loneliness Scale v3, Lawton IADL Scale, Mini-Mental State Examination (MMSE), and Yesavage's Geriatric Depression Scale. Samples were matched: 85 per group, 82.4% were women, married (52.95%), and mean age of 69.17 (±6.93) years. In our study, 30% displayed moderate to high levels of perceived loneliness. Multivariate analysis showed loneliness was associated with depression, low levels of IADL, and older age, but not with cognitive symptoms, which explained 22% of the total variance (F 165) = 16.99, (p < 0.001). Targeting symptoms and behaviors that could be modified (i.e., depression and functionality) can improve feelings of perceived loneliness and have an impact on morbidity and mortality with which it is associated.

Mortality risk of loneliness: Culture matters.

OBJECTIVE: Does loneliness predict premature death? Much prior research suggests so, but this evidence draws primarily on populations from individualistic societies, such as North America and Western Europe. Here, we aimed to extend this evidence by testing a hypothesis that loneliness would predict greater mortality risk in collectivistic societies, where social interdependence is normatively sanctioned. METHOD: Using a harmonized dataset from two individualistic (England and the United States) and two collectivistic (Korea and Mexico) countries (combined N = 41,869), we tested whether cultural contexts moderate the extent to which loneliness predicts 10-year all-cause mortality. RESULTS: After adjustment of demographic variables and health behaviors, loneliness was associated with increased 10-year mortality in all four countries, with hazard ratios (HRs) of 1.13 in England, 1.21 in the United States and Mexico, and 1.51 in Korea. When health conditions were additionally controlled, this association became negligible in two individualistic countries, with HRs of 0.98 for both England and the United States. In contrast, the HR remained highly significant in Korea (HR = 1.27). Curiously, the mortality risk of loneliness in Mexico (HR = 1.03), another collectivistic country, was no different from the risks in England and the United States. CONCLUSIONS: When people feel that they are chronically isolated from social networks, this perception can be fatal in Korea, but it is less so in the other three countries. Discussion focuses on other cultural factors, besides the cultural dimension of individualism-collectivism, that may account for the current finding. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Loneliness as a predictor of mortality in cancer patients, a cohort study / La soledad como predictor de mortalidad en pacientes con cáncer, un estudio de cohorte

Introduction. Some studies have indicated that loneliness may be associated with an increased risk of mortality in cancer patients, as it can weaken treatment response and the immune system, and promote harmful behaviors, worsening the prognosis and increasing the likelihood of death. Addressing loneliness in public health is essential to provide social support and improve outcomes in cancer patients. Objective. To obtain an estimator of the unwanted loneliness-mortality association. Materials and methods. We followed a prospective cohort of 400 patients for two years (exposure=loneliness levels; outcome=mortality; sociodemographic and clinical control variables were included). A parametric survival model (log normal) was used. Results. The cohort had a median survival of 20.2 months and a mortality rate of 3.2 deaths/100 patient-months (95% CI: 2.8 to 3.7). The survival model found the following time ratios (TR): moderate level/low level: TR=0.55; 95% CI: 0.39 to 0.77; moderately high level/low level: TR=0.62; 95% CI: 0.41 to 0.93; high level/low level: TR=1.17; 95% CI: 0.31 to 4.42. Conclusion. Compared to patients with low levels of loneliness, patients with moderate or moderately high levels reach death more quickly (statistically significant TRs, adjusted for the effect of other variables in the model); this highlights the need for interventions to mitigate loneliness and promote social support in patients having cancer.

Introducción. Algunos estudios han señalado que la soledad podría estar relacionada con un aumento en el riesgo de mortalidad en pacientes con cáncer ya que puede debilitar la respuesta al tratamiento y del sistema inmunológico y promover comportamientos perjudiciales, lo que puede empeorar el pronóstico y aumentar la probabilidad de muerte en estos pacientes. El abordar la soledad en la salud pública es esencial para brindar apoyo social y mejorar los resultados en los pacientes con cáncer. Objetivo. Obtener un estimador de la asociación soledad no deseada - mortalidad en pacientes con cáncer. Materiales y métodos. Se le hizo el seguimiento durante dos años a una cohorte prospectiva de 400 pacientes (exposición=niveles de soledad; desenlace=tiempo hasta la muerte). Se incluyeron variables de control sociodemográficas y clínicas. Se utilizó un modelo de supervivencia paramétrico (log normal). Resultados. En la cohorte se encontró una mediana de supervivencia de 20,2 meses y una tasa de mortalidad de 3,2 muertes por 100 pacientes-mes (IC95 %: 2,8 a 3,7). En el modelo de supervivencia se encontraron las siguientes razones de tiempo (RT): nivel moderado-nivel bajo: RT=0,55; IC95 %: 0,39 a 0,77; nivel moderadamente alto-nivel bajo: RT=0,62; IC95 %: 0.41 a 0.93; nivel alto-nivel bajo: RT=1,17; IC95 %: 0,31 a 4,42. Conclusión. En comparación con los pacientes con niveles bajos de soledad, los pacientes con niveles moderados o moderadamente altos llegan más rápidamente a la muerte (RT estadísticamente significativas, habiendo ajustado por el efecto de las demás variables del modelo). Esto sugiere la utilidad de las intervenciones para mitigar la soledad y promover el apoyo social en los pacientes con cáncer.

Association between loneliness and mental health among nurses: a cross-sectional research in China.

This study explored the association between loneliness and mental health among nurses in China during the COVID-19 pandemic. This cross-sectional study was conducted from March to April 2022. We enrolled 2,811 nurses from a tertiary hospital in China. Demographic characteristics, lifestyle factors, work-related factors, and psychological characteristics were collected from participants via a self-reported questionnaire. Loneliness was measured with the three-item short form of the Revised UCLA Loneliness Scale, and the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale were used to measure mental health. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were determined using binary logistic regression. Among participants in this study, 12.0% (337) experienced loneliness, and 7.8% (219) and 6.7% (189) reported depression and anxiety, respectively. The loneliness scores were categorized into three levels (3, 4-6, and 7-9). For depression, compared with the lowest reference, the ORs and 95% CI across the tertile were 1.31 (0.69-1.84) and 2.53 (1.11-5.76) after adjustment, respectively, and the P-value for trend was 0.045. For anxiety, compared with the lowest reference, the ORs and 95%CI across the tertile were 1.84 (1.28-2.63) and 2.52 (1.57-4.10) after adjustment, respectively; the P-value for trend was 0.004. This study showed that loneliness was significantly associated with poor mental health among nurses during the COVID-19 pandemic. These findings suggested that medical establishments should offer interventions for nurses to prevent mental health problems by targeting this modifiable risk factor.

Elder Abuse and Depressive Symptoms: The Mediating Role of Loneliness in Older Adults.

BACKGROUND: Elder abuse (EA), depressive symptoms, and loneliness represent a growing risk to the health, well-being, and premature mortality of older adults. However, the role of loneliness in the relationship between EA and depressive symptoms has not yet been examined. AIMS: To investigate the associations between these constructs and to explore the possible mediating role of loneliness in the relationship between EA and depressive symptoms in a representative sample of older Mexican people. METHODS: A representative community-dwelling survey of older adults aged 60 and older was conducted in two cities in Mexico (Mexico City and Xalapa) in 2018-2019. Measurements of EA, loneliness, depressive symptoms, health, and sociodemographic data were collected. Regression and mediation models were tested to analyze the associations between these variables. RESULTS: The prevalence of EA was 16.3%, loneliness was 50%, and depressive symptoms were 25.5%. The odds ratio (OR) for the occurrence of depressive symptoms was 2.7 when the combined effects of EA and loneliness were considered. The proportion of the effect that could explain the mediating role of loneliness was 31%. CONCLUSION: To effectively reduce depressive symptoms in older individuals affected by emotional or psychological abuse and neglect, it is crucial to address both the mediating influence of loneliness and EA itself in therapeutic and preventive interventions.

Longitudinal cross-lagged analysis of depression, loneliness, and quality of life in 12 European countries.

BACKGROUND: In the older population, depression, loneliness, and quality of life are closely related, significantly influencing health status. This paper aimed (1) to investigate autoregressive and cross-lagged associations over 2 years between depression, loneliness, and quality of life, and (2) to examine sex-related differences in the 2-year associations between depression, loneliness, and quality of life in a large sample of European citizens aged ≥ 50 years. METHODS: This is a longitudinal analysis. We included 7.456 individuals (70.89 ± 7.64 years; (4.268 females) who responded to waves 7 (2017) and 8 (2019) of the SHARE project. The variables analyzed in both waves were depression, loneliness, and quality of life. RESULTS: Comparatively, females indicated higher depression and loneliness scores than males and a lower perception of quality of life. Autoregressive associations pointed that past depression, loneliness, and quality of life predicted their future episodes 2 years later (p < 0.001). The cross-lagged analysis of males showed positive and significant bidirectional associations between depression and loneliness 2 years later. Females also showed a positive and significant association between depression and loneliness, but loneliness was not associated with depression 2 years later. In turn, previous high levels of quality of life had a protective role in late depression and loneliness up to 2 years. CONCLUSIONS: This study highlighted the need to simultaneously assess and manage depression, loneliness, and quality of life in the older European population. It is suggested that sex-specific policies can be created, including social support, in order to reduce depression and loneliness, and promote quality of life.

Assessing the impact of small firm dynamics on public mental health amid the pandemic in Latin America.

OBJECTIVE: The aim of our study is to examine the relationship between the economic activity of small firms and the mental well-being of the population in five Latin American countries in the early stages of the pandemic. METHODS: We utilize the search volume of certain keywords on Google Trends (GT), such as "boredom," "frustration," "loneliness," "sleep", "anxiety", and "depression", as an indicator of the well-being of the population. By examining the data from Facebook Business Activity Trends, we investigate how social attention reacts to the activity levels of different economic sectors. RESULTS: Increased business activity is generally associated with reduced levels of boredom, loneliness, sleep problems and anxiety. The effect on depression varies by sector, with positive associations concentrated in onsite jobs. In addition, we observe that strict Non-Pharmaceutical Interventions (NPIs) tend to exacerbate feelings of boredom and loneliness, sleep issues, and anxiety. CONCLUSIONS: Our findings suggest a strong association between different indicators of psychological well-being and the level of activity in different sectors of the economy. Given the essential role of small and medium-sized enterprises (SMEs) in generating employment, especially during crises like the pandemic, it is imperative that they remain resilient and adaptable to support economic recovery and job preservation. To accomplish this, policymakers need to focus on providing financial stability and support for SMEs, fostering social support networks within companies, and incorporating mental health services into workplace environments. This comprehensive strategy can alleviate mental health challenges and enhance public health resilience.

Risk factors associated with loneliness among mexican-origin adults in southern Arizona.

This study examines factors associated with symptoms of loneliness among a sample (n = 213) of mostly Mexican-origin adults at risk of chronic diseases in Southern Arizona's Pima, Yuma, and Santa Cruz counties. It uses baseline data from a community-based participatory research partnership and multinominal logistic regression models. Controlling for chronic diseases and sociodemographic characteristics, perceived social support and hope exhibit negative main effects on loneliness when comparing individuals who experienced loneliness for 5-7 days in the preceding week with those who did not encounter such feelings during the same period (adjusted odds ratio, AOR = 0.49 and 0.47; 95% confidence interval, CI = 0.34-0.73 and 0.29-0.75, respectively). However, when considered together, perceived social support and hope display a positive and statistically significant combined effect on loneliness (AOR = 1.03; 95% CI = 1.01-1.06). Holding all covariates constant, individuals reporting loneliness for 5-7 days exhibit a relative risk ratio of 1.24 (95% CI = 1.06-1.46) for a one-unit increase in physical problem severity compared to those who do not experience loneliness. Moreover, being 65 years old or older (AOR = 0.16, 95% CI = 0.03-0.84), and having been born in Mexico and lived in the US for less than 30 years (AOR = 0.12, 95% CI = 0.02-0.74) are associated with negative main effects on loneliness when comparing individuals who experienced loneliness 1-2, and 5-7 days in the preceding week with those who did not feel loneliness during the same timeframe, respectively. Recognizing the crucial role of loneliness in shaping health outcomes for Mexican-origin adults, our findings underscore the significance of fostering supportive environments that not only enhance well-being but also cultivate robust community bonds within the US-Mexico border region.

Role adoption, anxiety, depression and loneliness in family caregivers of patients with chronic diseases.

OBJECTIVE: to describe and explore the relationship of loneliness, anxiety and depression with adoption of the caregiver role among individuals caring for people with chronic diseases in Colombia. METHODS: this was an exploratory and cross-sectional study involving 960 primary caregivers of individuals with chronic diseases. We applied the Caregiver Role Adoption Scale, the University of California at Los Angeles Loneliness Scale, and the Anxiety and Depression Scale. Principal component and multiple correspondence analyses were performed for clustering. RESULTS: among the participating caregivers, 40.8% reported experiencing depression, 59% reported anxiety, 54.6% reported moderate to severe loneliness, and 88.6% reported satisfactory adoption of the caregiver role. Caregivers who presented basic or insufficient role adoption levels tended to have higher scores for anxiety, depression and loneliness. CONCLUSION: adoption of the caregiver role is a mediator in the anxiety, depression and loneliness levels among caregivers. Strategies aimed at supporting caregivers should include training for the caregiver role to mitigate the negative impacts of anxiety, depression and loneliness. (1) More than half of the caregivers reported moderate or severe anxiety and loneliness. (2) Caregivers with low role adoption levels presented more anxiety, depression and loneliness. (3) Satisfactory adoption of the caregiver role reduces anxiety, depression and loneliness. (4) Role adoption should be intervened to reduce the impact on caregivers' mental health.

A importância da literacia digital no combate à solidão numa amostra de idosos portugueses não-institucionalizados / The importance of digital literacy in combating loneliness in a sample of non-institutionalized Portuguese elderly people

A solidão pode ser compreendida como a perceção da satisfação dos relacionamentos interpessoais que o individuo estabelece com o seu meio sociofamiliar. Queixas frequentes de solidão têm sido observadas na população idosa, impactada por um mundo cada vez mais automatizado, no qual esta faixa etária acaba por ser mais fragilizada com consequências na saúde física e mental. O objetivo central deste estudo passa pela compreensão do impacto da literacia digital no combate à solidão em idosos residentes no seu domicílio. Foram avaliados 31 idosos não-institucionalizados que frequentam, há 6 meses, as aulas de literacia digital de um Centro Educativo para Seniores. Para a recolha de dados foram utilizados o TilburgFrailty Test (TFI), o Six-item Cognitive Impairment Test, a Escala de Barthel, o Índice de Lawton & Brody, a Escala de Depressão Geriátrica, o Inventário de Ansiedade Geriátrica e a Escala de solidão. Os resultados indicam que os participantes detêm uma média de idades de 75,21 anos, (DP = 4,67) que a maioria são do sexo feminino (n = 22; 71%) e com escolaridade do 1º ao 4º ano (n = 16: 52%). Desde que frequentam as aulas, todos os participantes já sabem fazer chamadas pelo telemóvel (n = 31; 100%), 61,3% já sabem enviar mensagens (n = 19), 51,6% já aprenderam a fazer videochamadas (n = 16), 77,4% já tiram fotos e vídeos (n = 24) e 64,5% já falam com os seus familiares pelas redes socias (n = 20). Quando questionados sobre o impacto da literacia digital nassuas vidas, 87,1% afirma que os sentimentos de solidão e isolamento diminuíram (n = 27), assim como os sintomas de depressão e ansiedade (87,2%; n = 23).Os resultados obtidos colocam em manifesto a importância de fomentar a aprendizagem ao longo da vida,criando contextos educativos nos quais os idosos tenham oportunidade de adquirir conhecimentos que lhes permita estabelecer relações interpessoais significativas utilizando, para esse efeito, tecnologia digital.(AU)

Loneliness can be understood as the perception of satisfaction in the interpersonal relationships that the individual establishes with their socio-family environment. Frequent complaints of loneliness have been observed in the elderly population, impacted by an increasingly automated world, in which this age group ends up being more fragile with consequences for physical and mental health. This study aimed to understand the impact of digital literacy in combating loneliness in elderly people living at home.31 non-institutionalized elderly people who had been attending digital literacy classes at an Educational Center for Seniors for 6 months. For data collection were used the Tilburg Frailty Test, the Six-item Cognitive Impairment Test, the Barthel Scale, the Lawton & Brody Index, the Geriatric Depression Scale, the Geriatric Anxiety Scale, and the Loneliness Inventory. The results indicate that the participants have an average age of 75,21 years, (SD = 4.67) that the majority are female (n = 22; 71%) and with education from the 1st to the 4th year (n = 16: 52%). Since taking classes, all participants already know how to make calls on their cell phones (n = 31; 100%), 61.3% already know how to send messages (n = 19), 51.6% have already learned how to make video calls (n = 16), 77.4% already take photos and videos (n = 24) and 64.5% already talk to their family members on social networks (n = 20). When asked about the impact of digital literacy, 87.1% stated that feelings of loneliness and isolation had decreased (n = 27), as well as symptoms of depression and anxiety (87.2%; n = 23). The results obtained highlight the importance of promoting lifelong learning, creating educational contexts in which elderly people can acquire knowledge that allows them to establish meaningful interpersonal relationships, using digitally means.(AU)

Entre a solidão e a solitude: a vivência de mulheres idosas que moram sozinhas / Between loneliness and solitude: the experience of elderly women living alone

Buscou-se compreender que condições e significados abarcam uma boa relação das idosas com o fato de residirem sozinhas (solitude) e quais aspectos propiciam sentimentos de solidão. A investigação é qualitativa, de caráter exploratório, delineada por estudo de casos múltiplos. Foram entrevistadas quatro idosas residentes de Salvador/BA. Conclui-se que os sentimentos de solidão e solitude aparecem mais relacionados aos modos de vida/relações das idosas do que quanto ao fato de morar só.(AU)

We sought to understand what conditions and meaningsembrace a good elderly woman relation with the fact of living alone (solitude) and what aspects propitiate loneliness feelings. This search has a qualitative approach, exploratory, outlined by multiple study cases. Four elderly woman residents of Salvador(Brazil) were interviewed. Feelings of loneliness and solitude are more related with the ways of life/relations than of the fact of living alone itself.(AU)

La soledad como predictor de mortalidad en pacientes con cáncer, un estudio de cohorte / Loneliness as a predictor of mortality in cancer patients, a cohort study

Introducción. Algunos estudios han señalado que la soledad podría estar relacionada con un aumento en el riesgo de mortalidad en pacientes con cáncer ya que puede debilitar la respuesta al tratamiento y del sistema inmunológico y promover comportamientos perjudiciales, lo que puede empeorar el pronóstico y aumentar la probabilidad de muerte en estos pacientes. El abordar la soledad en la salud pública es esencial para brindar apoyo social y mejorar los resultados en los pacientes con cáncer. Objetivo. Obtener un estimador de la asociación soledad no deseada - mortalidad en pacientes con cáncer. Materiales y métodos. Se le hizo el seguimiento durante dos años a una cohorte prospectiva de 400 pacientes (exposición=niveles de soledad; desenlace=tiempo hasta la muerte). Se incluyeron variables de control sociodemográficas y clínicas. Se utilizó un modelo de supervivencia paramétrico (log normal). Resultados. En la cohorte se encontró una mediana de supervivencia de 20,2 meses y una tasa de mortalidad de 3,2 muertes por 100 pacientes-mes (IC95%: 2,8 a 3,7). En el modelo de supervivencia se encontraron las siguientes razones de tiempo (RT): nivel moderado-nivel bajo: RT=0,55; IC95%: 0,39 a 0,77; nivel moderadamente alto-nivel bajo: RT=0,62; IC95%: 0.41 a 0.93; nivel alto-nivel bajo: RT=1,17; IC95%: 0,31 a 4,42. Conclusión. En comparación con los pacientes con niveles bajos de soledad, los pacientes con niveles moderados o moderadamente altos llegan más rápidamente a la muerte (RT estadísticamente significativas, habiendo ajustado por el efecto de las demás variables del modelo). Esto sugiere la utilidad de las intervenciones para mitigar la soledad y promover el apoyo social en los pacientes con cáncer.

Introduction. Some studies have indicated that loneliness may be associated with an increased risk of mortality in cancer patients, as it can weaken treatment response and the immune system, and promote harmful behaviors, worsening the prognosis and increasing the likelihood of death. Addressing loneliness in public health is essential to provide social support and improve outcomes in cancer patients. Objective. To obtain an estimator of the unwanted loneliness-mortality association. Materials and methods. We followed a prospective cohort of 400 patients for two years (exposure=loneliness levels; outcome=mortality; sociodemographic and clinical control variables were included). A parametric survival model (log normal) was used. Results. The cohort had a median survival of 20.2 months and a mortality rate of 3.2 deaths/100 patient-months (95% CI: 2.8 to 3.7). The survival model found the following time ratios (TR): moderate level/low level: TR=0.55; 95% CI: 0.39 to 0.77; moderately high level/ low level: TR=0.62; 95% CI: 0.41 to 0.93; high level/low level: TR=1.17; 95% CI: 0.31 to 4.42. Conclusion. Compared to patients with low levels of loneliness, patients with moderate or moderately high levels reach death more quickly (statistically significant TRs, adjusted for the effect of other variables in the model); this highlights the need for interventions to mitigate loneliness and promote social support in patients having cancer.

Influencing factors of self-perceived aging among empty nesters: a cross-sectional study / Los factores que influyen en el envejecimiento autopercibido entre los que se encuentran en un nido vacío: un estudio transversal / Os fatores influenciadores da autopercepção do envelhecimento entre aninhos vazios: um estudo transversal

Introduction: The mental health issues faced by empty nesters deserve more attention. Studying self-perception of aging (SPA) and its influencing factors among empty nesters may help prevent negative SPA. Objective: To analyze situations and factors influencing SPA among elderly empty nesters, especially the mediating role of daily living ability and loneliness. Materials and Methods: A cross-sectional study was conducted in two communities in Binzhou City, Shandong Province of China. A total of 613 elderly empty nesters were studied using a self-designed general information questionnaire, the Brief Ageing Perception Questionnaire (B-APQ), the Activities of Daily Living (ADL) Scale, and the UCLA Loneliness Scale (ULS-6). Structural equation modeling (SEM) was used to analyze the relationships between variables. Results: Pathway analysis of SPA influencing factors shows that marital status, children's visits, and self-reported health had an indirect effect on SPA through loneliness. Chronic disease status had an indirect effect on SPA through daily living ability. Time outdoors had an indirect effect on SPA through activities of daily living and loneliness. Discussion: Daily life ability, chronic disease status, time outdoors, loneliness, self-reported health, marital status, and children's visits affected SPA among empty nesters. Conclusion: Empty nesters' SPA is relatively negative, and there are many influencing factors. It is important to improve empty nesters' abilities to manage healthcare tasks, increase outdoor activities and family members' care, and provide comprehensive interventions to help them navigate aging.

Introducción: Los problemas de salud mental que presentan las personas cuyos hijos ya no viven con ellas merecen mayor atención. El estudio de la autopercepción del envejecimiento y sus factores influyentes en esta población puede ayudar a la prevención de percepciones negativas del envejecimiento. Objetivo: Analizar las situaciones y factores influyentes en la autopercepción del envejecimiento de los adultos mayores cuyos hijos ya no viven con ellos, específicamente, el rol mediador de las actividades de la vida diaria y la soledad. Materiales y métodos: Se realizó un estudio transversal en 2 comunidades de la ciudad de Binzhou, provincia de Shandong, China. Se estudiaron 613 adultos mayores cuyos hijos ya no vivían con ellos, aplicando un cuestionario de información general, el Cuestionario Breve de Percepción del Envejecimiento (B-APQ), la Escala de Actividades de la Vida Diaria (ADL) y la Escala de Soledad de la Universidad de California (ULS-6). Se utilizaron modelos de ecuaciones estructurales para analizar las relaciones entre las variables. Resultados: El análisis de los factores influyentes en el envejecimiento autopercibido muestra que el estado civil, las visitas de los hijos y la soledad afectan de manera indirecta la autopercepción del envejecimiento. Asimismo, las enfermedades crónicas y la capacidad para realizar las actividades de la vida diaria afectan de manera indirecta la autopercepción del envejecimiento. Discusión: La capacidad para realizar actividades de la vida diaria, las enfermedades crónicas, salir, la soledad, el estado de salud autoreportado, el estado civil y las visitas de los hijos son algunos factores que influyen en la autopercepción del envejecimiento en esta población. Conclusión: La autopercepción del envejecimiento de las personas cuyos hijos ya no viven con ellas es relativamente negativa y hay muchos factores influyentes. Es importante mejorar el manejo que se le da a la salud de esta población, aumentando las actividades al aire libre y el cuidado de sus familiares e implementando intervenciones integrales para ayudarlos en el tratamiento del envejecimiento.

Introdução: Os problemas de saúde mental dos ninhos vazios merecem maior atenção. Estudar a autopercepção do envelhecimento da situação e os fatores de influência entre os ninhos vazios ajudaria os ninhos vazios a prevenirem a autopercepção negativa do envelhecimento. Objetivo: Analisar a situação e os fatores de influência da autopercepção do envelhecimento entre idosos de ninhos vazios, explicitando o papel mediador da capacidade de vida diária e da solidão nos fatores de influência da autopercepção do envelhecimento. Materiais e Métodos: Um estudo transversal foi realizado em 2 comunidades na cidade de Binzhou, na província de Shandong. 613 idosos de ninhos vazios foram pesquisados usando um questionário de informações gerais auto elaborado, Brief Aging Perceptions Questionnaire (B-APQ), Activities of Daily Living (ADL), Loneliness Scale-6 (ULS-6) e modelagem de equações estruturais foram usadas para analisar as relações entre as variáveis. Resultados: A análise do caminho da autopercepção do envelhecimento dos fatores que influenciam mostra: estado civil, filhos para visitar, autorrelato de saúde por meio da solidão tiveram efeito indireto na autopercepção do envelhecimento. O status de doenças crônicas através da capacidade de vida diária teve efeito indireto na autopercepção do envelhecimento. Sair de casa devido à capacidade de vida diária e à solidão teve efeito indireto na autopercepção do envelhecimento. Discussão: O efeito da capacidade de vida diária, doenças crônicas, saídas, solidão, autorrelato de saúde, estado civil e visita de crianças na autopercepção do envelhecimento entre pessoas com o ninho vazio. Conclusão: A autopercepção do envelhecimento dos ninhos vazios é relativamente negativa e há muitos fatores que influenciam. É importante melhorar a capacidade de gestão da saúde dos ninhos vazios, aumentar as atividades ao ar livre e o cuidado dos familiares, e adotar medidas de intervenção abrangentes para ajudá-los a tratar o envelhecimento.