Psychological interventions for loneliness and social isolation among older adults during medical pandemics: a systematic review and meta-analysis.

OBJECTIVES: There is little research conducted to systematically synthesize the evidence on psychological interventions for social isolation and loneliness among older adults during medical pandemics. This systematic review aims to address this information gap and provides guidance for planning and implementing interventions to prevent and reduce loneliness and social isolation for older adults, especially during medical pandemics. METHODS: Four electronic databases (EMBASE, PsychoInfo, Medline and Web of Science) and grey literature from 1 January 2000 to 13 September 2022 were searched for eligible studies on loneliness and social isolation. Data extraction and methodological quality assessment on key study characteristics were conducted independently by two researchers. Both qualitative synthesis and meta-analysis were used. RESULTS: The initial search yielded 3,116 titles. Of the 215 full texts reviewed, 12 intervention articles targeting loneliness during the COVID-19 pandemic met the inclusion criteria. No studies were found concerning intervention with respect to social isolation. Overall, interventions targeting social skills and the elimination of negativities effectively alleviated the feelings of loneliness in the older population. However, they had only short-term effects. CONCLUSION: This review systematically summarised the key characteristics and the effectiveness of existing interventions addressing loneliness in older adults during the COVID-19 pandemic. Future interventions should focus on social skills and eliminating negativities and be tailored to the needs and characteristics of older people. Repeated larger-scale randomized controlled trials and long-term effectiveness evaluations on this topic are warranted.

Prevalence of loneliness and social isolation among older adults during the COVID-19 pandemic: A systematic review and meta-analysis.

OBJECTIVES: Pandemics and their public health control measures have generally substantially increased the level of loneliness and social isolation in the general population. Because of the circumstances of aging, older adults are more likely to experience social isolation and loneliness during pandemics. However, no systematic review has been conducted or published on the prevalence of loneliness and/or social isolation among the older population. This systematic review and meta-analysis aims to provide up-to-date pooled estimates of the prevalence of social isolation and loneliness among older adults during the COVID-19 pandemic and other pandemics in the last two decades. DESIGN: EMBASE, PsychoINFO, Medline, and Web of Science were searched for relevant studies from January 1, 2000 to November 31, 2021 published in a variety of languages. Only studies conducted during the COVID-19 pandemic were selected in the review. RESULTS: A total of 30 studies including 28,050 participants met the inclusion criteria. Overall, the pooled period prevalence of loneliness among older adults was 28.6% (95% CI: 22.9-35.0%) and 31.2% for social isolation (95% CI: 20.2-44.9%). Prevalence estimates were significantly higher for those studies conducted post 3-month from the start of the COVID-19 pandemic compared to those conducted within the first 3 months of the pandemic. CONCLUSIONS: This review identifies the need for good quality longitudinal studies to examine the long-term impact of pandemics on loneliness and social isolation among older populations. Health policymaking and healthcare systems should proactively address the rising demand for appropriate psychological services among older adults.

Post-exercise cognitive testing to assess persisting alterations in athletes with a history of concussion.

Primary Objective: To determine whether a physical exercise protocol could reveal persistent cognitive alterations in university athletes with a history of concussion (HOC). Thirty-four HOC and 34 controls participated in this study.Research Design: Cross-sectional.Methods and Procedures: The exercise protocol consisted of a 20-min bout on a stationary bike at 80% of the theoretical maximal heart rate. Before and after the exercise, participants performed a computerized switch task designed specifically to recruit executive functions. Group × Condition (pre- and post-exercise) repeated measures of ANCOVAs for accuracy, reaction time, and inverse efficiency score on the switch task were conducted. Chi-square tests were run to determine if the proportion of HOC and controls who underperformed (at least 2SD lower than the control group's average score) at rest and post-exercise were similar. Whilst no interaction or main effects were found with ANCOVAs, significantly more HOC athletes (21%) underperformed following exercise than at rest (3%) on the switch task, p = .02. The current results indicate that an acute bout of exercise can reveal persistent alterations that are not present at rest in the protracted phase of concussion. They also highlight the importance of considering inter-individual differences in recovery trajectories.

Sex-dependent attenuation of plaque growth after treatment with bone marrow mononuclear cells.

There are clinically relevant differences in symptomatology, risk stratification, and efficacy of therapies between men and women with coronary artery disease. Sex-based differences in plaque attenuation after administration of bone marrow mononuclear cells (BMNCs) are unknown. Forty-five male and 57 female apolipoprotein-E knockout (apoE(-/-)) mice were fed a high-fat diet. At 14 weeks of age, animals received 4 biweekly intravenous sex-matched (males, n=11; females, n=13) or -mismatched (males, n=12; females, n=14) BMNCs obtained from C57BL6/J mice. The rest of the apoE(-/-) mice were vehicle treated (males, n=13; females, n=20) or were age-matched untreated controls (males, n=9; females, n=10). Aortic plaque burden, progenitor cell profiles in bone marrow (BM) and 22 circulating cytokines/chemokines were examined 1 week following the final injection. Only female BMNCs infused into male apoE(-/-) recipients significantly decreased plaque formation (P<0.001). This reparative response univariately correlated with increased CD34(+) (P=0.02), CD45(+) (P=0.0001), and AC133(+)/CD34(+) (P=0.001) cell percentages in the BM of recipients but not with total serum cholesterol or percentage of BM-CD31(+)/CD45(low) cells. In a multivariate analysis, BM-AC133(+)/CD34(+) and BM-CD45(+) percentage counts correlated with a lower plaque burden (P<0.05). Increased granulocyte colony-stimulating factor levels highly correlated with plaque attenuation (r=-0.86, P=0.0004). In untreated apoE(-/-) mice of either sex, BM-AC133(+)/CD34(+) cells rose initially and then fell as plaque accumulated; however, BM-AC133(+)/CD34(+) percentages were higher in females at all times (P