Objective: The purpose of this study was to evaluate the impact of objective isolation and loneliness on Medicare spending and outcomes. Method: We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to three-item loneliness scale) as predictors of subsequent Medicare spending. In multivariable regression adjusting for health and demographics, we determined marginal differences in Medicare expenditures. Secondary outcomes included spending by setting, and mortality. Results: Objective isolation predicts greater spending, US$1,644 (p < .001) per beneficiary annually, whereas loneliness predicts reduced spending, −US$768 (p < .001). Increased spending concentrated in inpatient and nursing home (skilled nursing facilities [SNFs]) care; despite more health care, objectively isolated beneficiaries had 31% (p < .001) greater risk of death. Loneliness did not predict SNF use or mortality, but predicted slightly less inpatient and outpatient care. Discussion: Objectively isolated seniors have higher Medicare spending, driven by increased hospitalization and institutionalization, and face greater mortality. Policies supporting social connectedness could reap significant savings.

Social Isolation and Medicare Spending: Among Older Adults, Objective Isolation Increases Expenditures While Loneliness Does Not

Effect of Epilepsy on Families, Communities, and Society.

https://www.mdpi.com/2227-9032/9/3/293/pdf

Trends and Effectiveness of ICT Interventions for the Elderly to Reduce Loneliness: A Systematic Review.

This descriptive, cross-sectional study identified the association of eHealth use, literacy, informational support, and health-promoting behaviors among older adults, as mediated by health self-efficacy. Convenience sampling was conducted at senior welfare centers in Chuncheon, in the Republic of Korea. Data analysis was performed using Pearson's correlation and via path analyses. The findings showed that eHealth use had an indirect effect on health-promoting behaviors, as mediated by self-efficacy. Informational support was indirectly mediated by self-efficacy and had direct effects upon health-promoting behaviors. eHealth can facilitate self-efficacy and health management, despite not having direct effects upon health-promoting behaviors themselves. Thus, older adults need to be prepared for the increased use of eHealth. In addition, healthcare professionals should support older people in their use of eHealth and encourage informational support through comprehensive interventions so as to facilitate self-efficacy and health behaviors.

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Association of eHealth Use, Literacy, Informational Social Support, and Health-Promoting Behaviors: Mediation of Health Self-Efficacy.

Difficulties associated with Autism Spectrum Disorders can cause considerable impact on personal, familial, social, educational and occupational functioning. Living with a child who has an Autism Spectrum Disorder can therefore pose a challenge to family members, including typically developing siblings. However, it is only in recent years that the experience of typically developing siblings has become a focal point. A systematic review using keywords across six databases was undertaken to summarise qualitative studies that focused on the experience of being a sibling of a child with an Autism Spectrum Disorder. Fifteen studies met inclusion criteria and a thematic synthesis was completed. The synthesis found that having a sibling who has an Autism Spectrum Disorder can impact typically developing sibling's self-identity and personal development in a number of ways. Similarly, interactions with the sibling who has Autism Spectrum Disorders and with other individuals can evoke a myriad of experiences that can both benefit and challenge typically developing siblings. The ability of typically developing siblings to cope with adverse experiences needs to remain a focus. This synthesis concludes that further research is needed to identify which methods are the most effective in supporting typically developing siblings of children with Autism Spectrum Disorders.

https://journals.sagepub.com/doi/pdf/10.1177/13591045211007921

A systematic review of the experience of being a sibling of a child with an autism spectrum disorder

A controlled trial of the SibworkS group program for siblings of children with special needs.

OBJECTIVE To systematically assess the relationship between computer-mediated communication and social function in older adults aged 55 or older. METHODS Embase, PsycINFO and PubMed were searched (database inception to December 2018). Where available, effect sizes (correlation r) with 95% confidence intervals and P values were calculated for individual studies. Of 4,139 eligible articles retrieved, 17 studies involving a pooled sample of 17,640 participants were included. RESULTS Frequent computer-mediated communication was significantly, albeit weakly, associated with higher levels of social support and connectedness (r range = 0.08 to 0.33, P < 0.05). One discrepant negative relationship was noted (r = -0.16, 95% CI [-0.30, -0.02], P = 0.03), involving a distinct sample of gamers. CONCLUSIONS Computer-mediated communication is related to amount of social functioning in older adults, although the causal nature of this relationship requires further longitudinal investigation. Sample confounds (eg socio-economic status and successful ageing) may limit the interpretation of these findings.

Computer-mediated communication and social support among community-dwelling older adults: A systematic review of cross-sectional data.

Background Children born preterm (<37 weeks’ gestation) have an increased risk of poor neurodevelopment, including lower intelligence quotient (IQ) scores compared with their term-born counterparts. Objective To explore the differences in psychometric scores for cognition and motor skills when they are age-standardized according to chronological age instead of corrected age for children born preterm. Methods We assessed = 554 children born <33 weeks’ gestation with the Bayley Scales of Infant Development, 2nd edition (mental and motor scores) at 18 months and the Weschler Abbreviated Scale of Intelligence (IQ score) at seven years of age. Scores were standardized according to chronological age and corrected age and differences between mean chronological and corrected scores were compared, along with the proportion of children whose scores could be classified as impaired. Results When scores were standardized according to chronological age instead of corrected age there was a large significant difference of 17.3 points on the mental scale (79.5 vs. 96.8, respectively) and 11.8 points on the motor scale (84.8 vs. 96.6, respectively) at 18 months. By seven years, the difference in IQ scores remained, although of a smaller magnitude at 1.9 points between mean chronological and corrected age scoring (97.2 vs. 99.1, respectively). Conclusion Consistent with previous literature, outcome assessments for preterm infants consistently differed according to use of chronological or corrected age to standardized scores. Cognitive scores were impacted more severely than motor scores, and differences were more substantial in early childhood than later in childhood. For clinical purposes, correction for preterm birth is only likely to have an impact during early childhood, however assessments for research purposes should continue to correct into childhood to account for the persistent bias due to preterm birth.

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Consequences of using chronological age versus corrected age when testing cognitive and motor development in infancy and intelligence quotient at school age for children born preterm.

Older adults were at particular risk for loneliness during the height of the COVID-19 pandemic. In this instance, the use of computers for communication (i.e. computer-mediated communication, CMC) ...

Belinda G. Fuss

Papers

A controlled trial of the SibworkS group program for siblings of children with special needs.

Computer-mediated communication and social support among community-dwelling older adults: A systematic review of cross-sectional data.

Consequences of using chronological age versus corrected age when testing cognitive and motor development in infancy and intelligence quotient at school age for children born preterm.

Social function and psychological wellbeing among older Australian users of computer-mediated communication: does social distancing impact use?