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      Associations between social isolation, loneliness, and objective physical activity in older men and women

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          Abstract

          Background

          The impact of social isolation and loneliness on health risk may be mediated by a combination of direct biological processes and lifestyle factors. This study tested the hypothesis that social isolation and loneliness are associated with less objective physical activity and more sedentary behavior in older adults.

          Methods

          Wrist-mounted accelerometers were worn over 7 days by 267 community-based men ( n = 136) and women ( n = 131) aged 50–81 years (mean 66.01), taking part in the English Longitudinal Study of Ageing (ELSA; wave 6, 2012–13). Associations between social isolation or loneliness and objective activity were analyzed using linear regressions, with total activity counts and time spent in sedentary behavior and light and moderate/vigorous activity as the outcome variables. Social isolation and loneliness were assessed with standard questionnaires, and poor health, mobility limitations and depressive symptoms were included as covariates.

          Results

          Total 24 h activity counts were lower in isolated compared with non-isolated respondents independently of gender, age, socioeconomic status, marital status, smoking, alcohol consumption, self-rated health, limiting longstanding illness, mobility limitations, depressive symptoms, and loneliness (β = − 0.130 , p = 0.028). Time spent in sedentary behavior over the day and evening was greater in isolated participants (β = 0.143 , p = 0.013), while light (β = − 0.143 , p = 0.015) and moderate/vigorous (β = − 0.112 , p = 0.051) physical activity were less frequent. Physical activity was greater on weekdays than weekend days, but associations with social isolation were similar. Loneliness was not associated with physical activity or sedentary behavior in multivariable analysis.

          Conclusions

          These findings suggest that greater social isolation in older men and women is related to reduced everyday objective physical activity and greater sedentary time. Differences in physical activity may contribute to the increased risk of ill-health and poor wellbeing associated with isolation.

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          Most cited references27

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          Social Isolation in America: Changes in Core Discussion Networks over Two Decades

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            Loneliness and Health: Potential Mechanisms

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              Validation of the GENEA Accelerometer.

              The study aims were: 1) to assess the technical reliability and validity of the GENEA using a mechanical shaker; 2) to perform a GENEA value calibration to develop thresholds for sedentary and light-, moderate-, and vigorous-intensity physical activity; and 3) to compare the intensity classification of the GENEA with two widely used accelerometers. A total of 47 GENEA accelerometers were attached to a shaker and vertically accelerated, generating 15 conditions of varying acceleration and/or frequency. Reliability was calculated using SD and intrainstrument and interinstrument coefficients of variation, whereas validity was assessed using Pearson correlation with the shaker acceleration as the criterion. Next, 60 adults wore a GENEA on each wrist and on the waist (alongside an ActiGraph and RT3 accelerometer) while completing 10-12 activity tasks. A portable metabolic gas analyzer provided the criterion measure of physical activity. Analyses involved the use of Pearson correlations to establish criterion and concurrent validity and receiver operating characteristic curves to establish intensity cut points. The GENEA demonstrated excellent technical reliability (CVintra = 1.4%, CVinter = 2.1%) and validity (r = 0.98, P < 0.001) using the mechanical shaker. The GENEA demonstrated excellent criterion validity using VO2 as the criterion (left wrist, r = 0.86; right wrist, r = 0.83; waist, r = 0.87), on par with the waist-worn ActiGraph and RT3. The GENEA demonstrated excellent concurrent validity compared with the ActiGraph (r = 0.92) and the RT3 (r = 0.97). The waist-worn GENEA had the greatest classification accuracy (area under the receiver operating characteristic curve (AUC) = 0.95), followed by the left (AUC = 0.93) and then the right wrist (AUC = 0.90). The accuracy of the waist-worn GENEA was virtually identical with that of the ActiGraph (AUC = 0.94) and RT3 (AUC = 0.95). The GENEA is a reliable and valid measurement tool capable of classifying the intensity of physical activity in adults.
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                Author and article information

                Contributors
                s.schrempft@ucl.ac.uk
                marta.jackowska@roehampton.ac.uk
                m.hamer@lboro.ac.uk
                a.steptoe@ucl.ac.uk
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                16 January 2019
                16 January 2019
                2019
                : 19
                : 74
                Affiliations
                [1 ]ISNI 0000 0001 0468 7274, GRID grid.35349.38, Department of Psychology, , University of Roehampton, ; London, SW15 5PJ UK
                [2 ]ISNI 0000 0004 1936 8542, GRID grid.6571.5, School of Sport, Exercise and Health Sciences, , Loughborough University, ; Loughborough, LE11 3TU UK
                [3 ]ISNI 0000000121901201, GRID grid.83440.3b, Department of Behavioural Science and Health, , University College London, ; 1-19 Torrington Place, London, WC1E 6BT UK
                Article
                6424
                10.1186/s12889-019-6424-y
                6335852
                30651092
                9a2bb08b-ffee-40d1-9e06-6d09dccf0ca1
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 August 2018
                : 10 January 2019
                Funding
                Funded by: British Heart Foundation
                Award ID: PG/13/65/30440
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                social isolation,loneliness,objective physical activity,ageing,older adults
                Public health
                social isolation, loneliness, objective physical activity, ageing, older adults

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