Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study

Copyright: © 2021 by the authors. The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during COVID-19 with 6% retrospectively reporting severe loneliness prior to the pandemic. A fifth were defined as isolated based on their usual connections, with 13% reporting a substantial increase in isolation during COVID-19. Personal finances and mental health were overarching and consistently cross-cutting predictors of loneliness and social isolation, both before and during the pandemic. With the likelihood of future waves of COVID-19 and related restrictions, it must be a public health priority to address the root causes of loneliness and social isolation and, in particular, address the needs of specific groups such as carers or those living alone

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Social support mediates the relationships between extraversion, neuroticism, and cognitive function in older adults

Objectives We supplement existing findings on a link between social support and cognitive function in later life by considering the role of personality as an antecedent to both, and of social support as a mediator of the link between personality and cognitive function. Study design An observational cohort study. Methods We evaluated social support using the Lubben Social Network Scale, across 624 adults aged over 60 years, and investigated this measure as a mediator of the relationships between extraversion and neuroticism at baseline 2007–2009, and cognitive function at follow-up, 2 years later. A half-longitudinal mediation design, within a structural equation modelling framework, was used. Results There was a direct effect of extraversion, such that lower levels were related to higher scores of cognitive function. There was no significant direct effect of neuroticism on cognitive function at follow-up. Social support partially mediated the paths between both extraversion and neuroticism and cognitive function at follow-up. Decomposing the mediation effects by using social support subscales (measuring support from friends, relatives and neighbours) showed meaningful indirect effects for both predictors. Conclusion Results suggest that social support may offer a target for interventions for cognitively at-risk older adults and add to the existing empirical evidence describing the link between personality and cognitive function

New insights into loneliness and its treatment in older adults

Loneliness is a well-studied construct in the social sciences, in the epidemiology of aging and increasingly in gerontology but it is a relatively uncommon focus in psychiatric research. Loneliness is a perceived state of social and emotional isolation that is distinct from objective social isolation. Loneliness is understood to be both a perception and an emotion and may be a form of psychosocial stress. In large population-based studies, there is strong evidence that both loneliness and lower social engagement are independent predictors of accelerated cognitive decline and incident AD dementia. Psychosocial factors influencing loneliness are well known whereas little is known of the neurobiology and pathological correlates of loneliness, particularly in older people. The goal of this session is to illustrate the importance of social function and wellbeing to longitudinal cognition and Alzheimer's disease progression in older adults. The four speakers will provide data from their own research examining associations of loneliness and social engagement to cognition and Alzheimer's disease biomarkers. Dr. Joanna McHugh Power will describe six-year data defining patterns of loneliness and social isolation that are most predictive of semantic memory declines in over 8,000 participants from the Irish Longitudinal Study of Ageing. Dr. Nancy Donovan (Chair) will present a cross-sectional study defining associations of greater loneliness with higher cortical amyloid burden and regional tau deposition in a sample of cognitively normal older adults from the Harvard Aging Brain Study. Kelsey Biddle from Dr. Donovan's group will describe longitudinal data from the Harvard Brain Study examining cortical amyloid deposition, cognition and psychosocial factors that are predictive of decline in social engagement over 3 years among cognitively normal elderly. Dr. Phaedra Bell will present data from a pilot study focusing on lonely older adults to assess the impact of a multimodal intergenerational intervention on ratings of loneliness and mood in these participants. Finally, Dr. McHugh Power (Discussant) will lead the speakers in a panel discussion, along with Q&A involving session attendees

Exposure to the troubles in Northern Ireland, memory functioning, and social activity engagement: results from NICOLA

We investigated the potential impact of a cohort traumatic exposure, the Troubles in Northern Ireland, on memory functioning in later life, and the potential moderating effect of social activity engagement. Using data from 6571 participants aged 60 + in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) cohort, we used a structural equation modelling framework to explore associations between traumatic exposure during the Troubles and memory functioning. As expected, social activity engagement was positively associated with memory functioning, β = .102. Traumatic exposure was also positively associated with memory functioning, β = .053. This association was stronger at low levels of social activity engagement; among those with higher levels, there was little association, interaction β = − 0.054. The positive association between traumatic exposure during the Troubles and memory functioning was not moderated by the age at which the exposures occurred (based on analysis of a subsample with available data), interaction β = − 0.015. We conclude that superior memory functioning was associated with higher levels of traumatic exposure during the Troubles, particularly among those with lower levels of social activity engagement, and regardless of the age at which the exposures occurred. Future longitudinal analyses are required to build on these results, which potentially have implications for life-course epidemiology, in relation to critical periods for traumatising experiences. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10433-022-00683-5