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Social connections have a significant impact on health across age groups, including older adults. Loneliness and social isolation are known risk factors for Alzheimer’s disease and related dementias (ADRD). Yet, we did not find a review focused on meta-analyses and systematic reviews of studies that had examined associations of social connections with cognitive decline and trials of technology-based and other social interventions to enhance social connections in people with ADRD.
Study design:
We conducted a scoping review of 11 meta-analyses and systematic reviews of social connections as possible determinants of cognitive decline in older adults with or at risk of developing ADRD. We also examined eight systematic reviews of technology-based and other social interventions in persons with ADRD.
Study results:
The strongest evidence for an association of social connections with lower risk of cognitive decline was related to social engagement and social activities. There was also evidence linking social network size to cognitive function or cognitive decline, but it was not consistently significant. A number of, though not all, studies reported a significant association of marital status with risk of ADRD. Surprisingly, evidence showing that social support reduces the risk of ADRD was weak. To varying degrees, technology-based and other social interventions designed to reduce loneliness in people with ADRD improved social connections and activities as well as quality of life but had no significant impact on cognition. We discuss strengths and limitations of the studies included.
Conclusions:
Social engagement and social activities seem to be the most consistent components of social connections for improving cognitive health among individuals with or at risk for ADRD. Socially focused technology-based and other social interventions aid in improving social activities and connections and deserve more research.
Older adults with serious mental illness (SMI) often have poor physical health in addition to serious mental health issues. Sustained engagement in a group physical activity program may provide necessary physical and mental health benefits. The purpose of this report is to describe participants’ feedback about a video game-based group physical activity program using the Kinect for Xbox 360 game system (Microsoft, Redmond, WA). In particular, we wanted to understand what worked about the program, what was not ideal, and how it impacted their lives.
Design:
Semi-structured interviews were collected and analyzed with grounded theory methodology.
Setting:
Mental health facility.
Participants:
Sixteen older adults with SMI.
Measurements:
Participants played an active video game for 50-minute sessions, three times a week for 10 weeks. Qualitative interviews were conducted with 16 participants upon completion of the program.
Results:
Participants expressed enthusiasm for the physical activity program, indicating it was an activity that they looked forward to doing. The results of the study provide insight into how the program may be implemented into practice at mental health facilities. Three implementation to practice categories were identified: (1) programmatic considerations, such as when to hold the groups and where; (2) the critical importance of staff involvement; and (3) harnessing patients’ interest in the program.
Conclusion:
Our results suggest that engagement in an intense video game-based group physical activity program has a positive impact on participants’ overall health. The group atmosphere, staff involvement, availability of the program at a mental health facility, and health benefits were critical.
The burgeoning population of older adults with schizophrenia and other serious mental illnesses is on pace to overwhelm already-strained health care and long-term care systems in the U.S. Reducing premature institutionalization and excess risk of early mortality while enhancing community tenure among older adults with schizophrenia would not only help to mitigate the impact on various systems of care, but also satisfy the preferences of most older adults with schizophrenia. Many factors leading to premature institutionalization and death for these patients stem from co-occurring preventable chronic health conditions and modifiable health behaviors. In response to the health disparities facing this population, innovative model programs and interventions aiming to ameliorate health and wellbeing, while promoting community-living skills have emerged. In this chapter, we provide an overview of the research supporting current innovative model programs and three key approaches to addressing these challenges: illness self-management, psychosocial rehabilitation, and health promotion. Based on key strengths of the nine model programs and interventions detailed within, we offer novel strategies for future models with an emphasis on reach and sustainability at the population health level.
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