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      Maintenance of high quality of life as an indicator of resilience during COVID-19 social distancing among community-dwelling older adults in Finland

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          Abstract

          Purpose

          Social distancing during the COVID-19 pandemic reduced possibilities for activities of choice potentially threatening quality of life (QoL). We defined QoL resilience as maintaining high quality of life and studied whether walking speed, absence of loneliness, living arrangement, and stress-coping ability predict QoL resilience among older people.

          Methods

          Community-dwelling 75-, 80-, and 85-year-old persons ( n = 685) were interviewed and examined in 2017–2018 and were followed up during COVID-19 social distancing in 2020. We assessed QoL using the OPQOL-brief scale and set a cut-off for ‘constant high’ based on staying in the highest baseline quartile over the follow-up and categorized all others as having ‘low/moderate’. Perceived restrictiveness of the social distancing recommendations was examined with one item and was categorized as ‘yes’ or ‘no’ restrictiveness.

          Results

          Better stress-coping ability (OR 1.21, 95% CI 1.14–1.28) and not being lonely (OR 2.67, 95% CI 1.48–4.63) increased the odds for constant high QoL from before to amid social distancing, and the odds did not differ according to the perceived restrictiveness of the social distancing recommendations. Higher walking speed predicted constant high QoL only among those perceiving restrictiveness (OR 1.16, 95% CI 1.07–1.27). Living arrangement did not predict constant high QoL.

          Conclusion

          During social distancing, psychosocial resources helped to maintain good QoL regardless how restrictive the social distancing recommendations were perceived to be. Better physical capacity was important for constant high QoL only among those perceiving restrictiveness presumably because it enabled replacing blocked activities with open outdoor physical activities.

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          Most cited references45

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          “Mini-mental state”

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            Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

            Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.
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              Loneliness and social isolation as risk factors for mortality: a meta-analytic review.

              Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.
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                Author and article information

                Contributors
                kaisa.m.koivunen@jyu.fi
                Journal
                Qual Life Res
                Qual Life Res
                Quality of Life Research
                Springer International Publishing (Cham )
                0962-9343
                1573-2649
                27 September 2021
                27 September 2021
                : 1-10
                Affiliations
                [1 ]GRID grid.9681.6, ISNI 0000 0001 1013 7965, Gerontology Research Center and Faculty of Sport and Health Sciences, , University of Jyväskylä, ; PO Box 35, 40014 Jyväskylä, Finland
                [2 ]GRID grid.4830.f, ISNI 0000 0004 0407 1981, Present Address: Department of Human Movement Sciences, University Medical Center Groningen, , University of Groningen, ; Groningen, The Netherlands
                [3 ]GRID grid.452494.a, ISNI 0000 0004 0409 5350, Institute for Molecular Medicine Finland (FIMM), ; Helsinki, Finland
                Author information
                http://orcid.org/0000-0002-0710-0069
                Article
                3002
                10.1007/s11136-021-03002-0
                8475423
                34570331
                54dd07f9-2b7e-403c-b14d-b87eec4b9975
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 17 September 2021
                Funding
                Funded by: European Research Council
                Award ID: 693045
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100002341, Academy of Finland;
                Award ID: 310526
                Award ID: 323541
                Award Recipient :
                Funded by: The Finnish Ministry of Education and Culture
                Funded by: University of Jyväskylä (JYU)
                Categories
                Article

                Public health
                physical function,psychosocial resources,adversity,adaptation
                Public health
                physical function, psychosocial resources, adversity, adaptation

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