Funcionalidad y soledad en personas mayores: Modelo de mediación por el afecto positivo
Resumen
Objetivo: La soledad se asocia a la discapacidad funcional en la población mayor, aunque se sabe poco sobre el papel de la afectividad en esta relación. Nos proponemos explorar el efecto mediador de la afectividad en la relación entre funcionalidad y soledad, controlando el efecto de las variables relevantes. Métodos: Se administró la Escala de Soledad de la Universidad de California-16, la Escala de Funcionalidad Geriátrica, las Escalas de Afecto Positivo y Negativo-14 y la Escala de Depresión Geriátrica-8 a 489 adultos mayores (65–100 años), 428 de residencias geriátricas y 61 de la comunidad. Resultados: Los residentes en una institución, mujeres, viudos, con baja educación, más discapacidad funcional, más afecto negativo, menos afecto positivo y más síntomas depresivos reportaron más soledad. Controlando el efecto de los síntomas depresivos, género, situación residencial, estado civil y educación, solo el afecto positivo medió, parcialmente, la relación entre funcionalidad y soledad. Conclusión: Se sugieren intervenciones para aumentar la concienciación por parte de los adultos mayores en los perfiles personalizados de afecto positivo, aliviando así los sentimientos de soledad en los que sufren limitaciones funcionales (especialmente mujeres, con síntomas depresivos, viudos, residiendo en una institución y con bajo nivel educativo).
Descargas
Citas
Aanes, M. M., Mittelmark, M. B., & Hetland, J. (2009). The experience of loneliness: Main and interactive effects of interpersonal stress, social support and positive affect. International Journal of Mental Health Promotion, 11(4), 25–33. https://doi.org/10.1080/14623730.2009.9721797
Aartsen, M., & Jylhä, M. (2011). Onset of loneliness in older adults: Results of a 28 year prospective study. European Journal of Ageing, 8(1), 31–38. https://doi.org/10.1007/s10433-011-0175-7
Barakat, M. M., Elattar, N. F., & Zaki, H. N. (2019). Depression, anxiety and loneliness among elderly living in geriatric homes. American Journal of Nursing Research, 7(4), 400–411. https://doi.org/10.12691/ajnr-7-4-1
Bekhet, A. K., & Zauszniewski, J. A. (2012). Mental health of elders in retirement communities: Is loneliness a key factor? Archives of Psychiatric Nursing, 26(3), 214–224. https://doi.org/10.1016/j.apnu.2011.09.007
Berg, S., Mellstrom, D., Persson, G., & Svanborg, A. (1981). Loneliness in the Swedish aged. Journal of Gerontology, 36(3), 342–349. https://doi.org/10.1093/geronj/36.3.342
Böger, A., & Huxhold, O. (2018). Do the antecedents and consequences of loneliness change from middle adulthood into old age? Developmental Psychology, 54(1), 181–197. https://doi.org/10.1037/dev0000453
Burton, R. L., O’Connell, M. E., & Morgan, D. G. (2018). Cognitive and neuropsychiatric correlates of functional impairment across the continuum of no cognitive impairment to dementia. Archives of Clinical Neuropsychology, 33(7), 795–807. https://doi.org/10.1093/arclin/acx112
Cacioppo, S., Capitanio, J. P., & Cacioppo, J. T. (2014). Toward a neurology of loneliness. Psychological Bulletin, 140(6), 1464–1504. https://doi.org/10.1037/a0037618
Carstensen, L. L., Fung, H. H., & Charles, S. T. (2003). Socioemotional selectivity theory and the regulation of emotion in the second half of life. Motivation and Emotion, 27(2), 103–123. https://doi.org/10.1023/A:1024569803230
Craske, M. G., Meuret, A. E., Ritz, T., Treanor, M., Dour, H., & Rosenfield, D. (2019). Positive affect treatment for depression and anxiety: A randomized clinical trial for a core feature of anhedonia. Journal of Consulting and Clinical Psychology, 87(5), 457–471. https://doi.org/10.1037/ccp0000396
Dahlberg, L., & McKee, K. J. (2014). Correlates of social and emotional loneliness in older people: Evidence from an English community study. Aging & Mental Health, 18(4), 504–514. https://doi.org/10.1080/13607863.2013.856863
Daniel, F., Vicente, H., Guadalupe, S., Silva, A., & Santo, H. M. A. E. (2015). Propriedades psicométricas da versão portuguesa do Inventário Geriátrico de Ansiedade numa amostra de idosos utentes de estruturas residenciais [Psychometric properties of the Portuguese version of the Geriatric Anxiety Inventory in a sample of elderly users of residential structures]. Revista Portuguesa de Investigação Comportamental e Social, 1(2), 15–30. https://doi.org/10.7342/ismt.rpics.2015.1.2.22
Direção-Geral da Saúde. (2004). Classificação Internacional de Funcionalidade, Incapacidade e Saúde. https://www.dgs.pt/estatisticas-de-saude/documentos-para-download/classificacao-internacional-de-funcionalidade-incapacidade-e-saude-cif-pdf.aspx
Domènech-Abella, J., Lara, E., Rubio-Valera, M., Olaya, B., Moneta, M. V., Rico-Uribe, L. A., Ayuso-Mateos, J. L., Mundó, J., & Haro, J. M. (2017). Loneliness and depression in the elderly: The role of social network. Social Psychiatry and Psychiatric Epidemiology, 52(4), 381–390. https://doi.org/10.1007/s00127-017-1339-3
Dong, X., & Chen, R. (2017). Gender differences in the experience of loneliness in U.S. Chinese older adults. Journal of Women & Aging, 29(2), 115–125. https://doi.org/10.1080/08952841.2015.1080534
Dong, X., Simon, M. A., Gorbien, M., Percak, J., & Golden, R. (2007). Loneliness in older Chinese adults: A risk factor for elder mistreatment. Journal of the American Geriatrics Society, 55(11), 1831–1835. https://doi.org/10.1111/j.1532-5415.2007.01429.x
Drageset, J. (2004). The importance of activities of daily living and social contact for loneliness: A survey among residents in nursing homes. Scandinavian Journal of Caring Sciences, 18(1), 65–71. https://doi.org/10.1111/j.0283-9318.2003.00251.x
Drennan, J., Treacy, P. M., Butler, M., Byrne, A., Fealy, G., Frazer, K., & Irving, K. (2008). The experience of social and emotional loneliness among older people in Ireland. Ageing and Society, 28(8), 1113–1132. https://doi.org/0.1017/S0144686X08007526
Dykstra, P. A., & de Jong Gierveld, J. (1999). [Differential indicators of loneliness among elderly. The importance of type of partner relationship, partner history, health, socioeconomic status and social relations]. Tijdschrift Voor Gerontologie En Geriatrie, 30(5), 212–225.
Dykstra, P. A., & de Jong Gierveld, J. (2004). Gender and marital-history differences in emotional and social loneliness among Dutch older adults. Canadian Journal on Aging, 23(2), 141–155. https://doi.org/10.1353/cja.2004.0018
Espírito-Santo, H., Lemos, L., Pena, I., Guadalupe, S., Gordo, S., Daniel, F., & Vicente, H. (2014). 199—Development of a Geriatric Functionality Scale to screen for functional ability. Revista de Saúde Pública, 48(n.esp), 124.
Figueiredo-Duarte, C., Espirito-Santo, H., Sério, C., Lemos, L., Marques, M., & Daniel, F. (2021). Validity and reliability of a shorter version of the Geriatric Depression Scale in institutionalized older Portuguese adults. Aging and Mental Health, 25(3), 492–498. https://doi.org/hd8b
Fritz, M. S., & MacKinnon, D. P. (2007). Required sample size to detect the mediated effect. Psychological science, 18(3), 233–239. https://doi.org/10.1111/j.1467-9280.2007.01882.x
Gable, S. L., Reis, H. T., & Elliot, A. J. (2000). Behavioral activation and inhibition in everyday life. Journal of Personality and Social Psychology, 78(6), 1135–1149. https://doi.org/10.1037/0022-3514.78.6.1135
Gonyea, J. G., Curley, A., Melekis, K., Levine, N., & Lee, Y. (2018). Loneliness and depression among older adults in urban subsidized housing. Journal of Aging and Health, 30(3), 458–474. https://doi.org/10.1177/0898264316682908
Guo, L., An, L., Luo, F., & Yu, B. (2021). Social isolation, loneliness and functional disability in Chinese older women and men: A longitudinal study. Age and Ageing, 50(4), 1222–1228. https://doi.org/10.1093/ageing/afaa271
Hajek, A., & König, H.-H. (2020). Which factors contribute to loneliness among older Europeans? Findings from the Survey of Health, Ageing and Retirement in Europe. Journal Pre-proof, 89(104080). https://doi.org/10.1016/j.archger.2020.104080
Hansen, T., & Slagsvold, B. (2016). Late-life loneliness in 11 European countries: Results from the Generations and Gender Survey. Social Indicators Research, 129(1), 445–464. https://doi.org/10.1007/s11205-015-1111-6
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 40(2), 218–227. https://doi.org/10.1007/s12160-010-9210-8
Hawkley, L. C., Hughes, M. E., Waite, L. J., Masi, C. M., Thisted, R. A., & Cacioppo, J. T. (2008). From social structural factors to perceptions of relationship quality and loneliness: The Chicago health, aging, and social relations study. The Journals of Gerontology: Series B, 63(6), S375–S384. https://doi.org/10.1093/geronb/63.6.S375
Hawkley, L. C., & Kocherginsky, M. (2018). Transitions in loneliness among older adults: A five-year follow-up in the National Social Life, Health, and Aging Project. Research on Aging, 40(4), 365–387. https://doi.org/10.1177/0164027517698965
Hayes, A. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (2nd ed.). Guilford Press.
JASP Team. (2020). JASP (Version 0.14.1).
Kharicha, K., Manthorpe, J., Iliffe, S., Davies, N., & Walters, K. (2018). Strategies employed by older people to manage loneliness: Systematic review of qualitative studies and model development. International Psychogeriatrics, 30(12), 1767–1781. https://doi.org/10.1017/S1041610218000339
Koch, S., Kunz, T., Lykou, S., & Cruz, R. (2014). Effects of dance movement therapy and dance on health-related psychological outcomes: A meta-analysis. The Arts in Psychotherapy, 41(1), 46–64. https://doi.org/10.1016/j.aip.2013.10.004
Lee, E. E., Depp, C., Palmer, B. W., Glorioso, D., Daly, R., Liu, J., Tu, X. M., Kim, H.-C., Tarr, P., Yamada, Y., & Jeste, D. V. (2019). High prevalence and adverse health effects of loneliness in community-dwelling adults across the lifespan: Role of wisdom as a protective factor. International Psychogeriatrics, 31(10), 1447–1462. https://doi.org/10.1017/S1041610218002120
Lemos, L., Espirito-Santo, H., Duarte-Figueiredo, C., Santos, D., Cunha, L., & Fernanda Daniel, F. (2019). Validação da PANAS numa amostra portuguesa de pessoas idosas em resposta social. Revista Portuguesa de Investigação Comportamental e Social, 5(2), 49–67. https://doi.org/10.31211/rpics.2019.5.2.160
López Doblas, J., & Díaz Conde, M. D. P. (2018). Viudedad, soledad y salud en la vejez [Widowhood, loneliness, and health in old age]. Revista Española De Geriatría y Gerontología, 53(3), 128–133. https://doi.org/10.1016/j.regg.2017.09.005
Macdonald, S. J., Deacon, L., Nixon, J., Akintola, A., Gillingham, A., Kent, J., Gillian, E., Mathews, D., Ismail, A., Sullivan, D., & Higmore, L. (2018). ’The invisible enemy’: Disability, loneliness and isolation. Disability & Society, 33(7), 1138–1159. https://doi.org/10.1080/09687599.2018.1476224
Nolen-Hoeksema, S., & Aldao, A. (2011). Gender and age differences in emotion regulation strategies and their relationship to depressive symptoms. Personality and Individual Differences, 51(6), 704–708. https://doi.org/10.1016/j.paid.2011.06.012
O’Súilleabháin, P. S., Gallagher, S., & Steptoe, A. (2019). Loneliness, living alone, and all-cause mortality: The role of emotional and social loneliness in the elderly during 19 years of follow-up. Psychosomatic Medicine, 81(6), 521–526. https://doi.org/10.1097/PSY.0000000000000710
Peerenboom, L., Collard, R. M., Naarding, P., & Comijs, H. C. (2015). The association between depression and emotional and social loneliness in older persons and the influence of social support, cognitive functioning and personality: A cross-sectional study. Journal of Affective Disorders, 182, 26–31. https://doi.org/10.1016/j.jad.2015.04.033
Perissinotto, C. M., Cenzer, I. S., & Covinsky, K. E. (2012). Loneliness in older persons: A predictor of functional decline and death. Archives of internal medicine, 172(14), 1078–1083. https://doi.org/10.1001/archinternmed.2012.1993
Phillips, W. J., & Ferguson, S. J. (2013). Self-compassion: A resource for positive aging. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 68(4), 529–539. https://doi.org/10.1093/geronb/gbs091
Pocinho, M., Farate, C., & Dias, C. A. (2010). Validação psicométrica da escala UCLA-loneliness para idosos portugueses [Psychometric validation of the UCLA-loneliness scale for Portuguese elderly]. Interações: Sociedade e as novas modernidades, 10(18), 65–77.
Prakash, R. S., Hussain, M. A., & Schirda, B. (2015). The role of emotion regulation and cognitive control in the association between mindfulness disposition and stress. Psychology and Aging, 30(1), 160–171. https://doi.org/10.1037/a0038544
Preacher, K. J., & Kelley, K. (2011). Effect size measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods, 16(2), 93–115. https://doi.org/10.1037/a0022658
Qualter, P., Vanhalst, J., Harris, R., Van Roekel, E., Lodder, G., Bangee, M., Maes, M., & Verhagen, M. (2015). Loneliness across the life span. Perspectives on Psychological Science, 10(2), 250–264. https://doi.org/10.1177/1745691615568999
Rodrigues, V., Costa, C., Carvalho, A., Vidal, M., Caiado, M., Antunes, C., Almeida, A., & Almeida, C. (2019). Solidão no idoso institucionalizado com dependência funcional [Loneliness in the institutionalized elderly person with functional dependence]. Motricidade, 15(4), 36–40. https://doi.org/10.6063/MOTRICIDADE.20137
Russell, D., Peplau, L. A., & Ferguson, M. L. (1978). Developing a measure of Loneliness. Journal of Personality and Social Psychology, 42(3), 290–294. https://doi.org/10.1207/s15327752jpa4203_11
Savikko, N., Routasalo, P., Tilvis, R. S., Strandberg, T. E., & Pitkälä, K. H. (2005). Predictors and subjective causes of loneliness in an aged population. Archives of Gerontology and Geriatrics, 41(3), 223–233. https://doi.org/10.1016/j.archger.2005.03.002
Scheibe, S., Sheppes, G., & Staudinger, U. M. (2015). Distract or reappraise? Age-related differences in emotion-regulation choice. Emotion, 15(6), 677–681. https://doi.org/10.1037/a0039246
Schilling, O. K., Wahl, H.-W., Boerner, K., Horowitz, A., Reinhardt, J. P., Cimarolli, V. R., Brennan-Ing, M., & Heckhausen, J. (2016). Developmental regulation with progressive vision loss: Use of control strategies and affective well-being. Developmental Psychology, 52(4), 679–694. https://doi.org/10.1037/dev0000099
Shook, N. J., Ford, C., Strough, J., Delaney, R., & Barker, D. (2017). In the moment and feeling good: Age differences in mindfulness and positive affect. Translational Issues in Psychological Science, 3(4), 338–347. https://doi.org/10.1037/tps0000139
Shovestul, B., Han, J., Germine, L., & Dodell-Feder, D. (2020). Risk factors for loneliness: The high relative importance of age versus other factors. PLOS ONE, 15(2), e0229087. https://doi.org/10.1371/journal.pone.0229087
Stewart, M., Craig, D., MacPherson, K., & Alexander, S. (2001). Promoting positive affect and diminishing loneliness of widowed seniors through a support intervention. Public Health Nursing, 18(1), 54–63. https://doi.org/10.1046/j.1525-1446.2001.00054.x
Templeton, G. F. (2011). A two-step approach for transforming continuous variables to normal: Implications and recommendations for IS research. Communications of the Association for Information Systems, 28, https://doi.org/10.17705/1CAIS.02804
Theeke, L. A. (2009). Predictors of loneliness in U.S. adults over age sixty-five. Archives of Psychiatric Nursing, 23(5), 387–396. https://doi.org/10.1016/j.apnu.2008.11.002
Tiikkainen, P., & Heikkinen, R.-L. (2005). Associations between loneliness, depressive symptoms and perceived togetherness in older people. Aging & Mental Health, 9(6), 526–534. https://doi.org/10.1080/13607860500193138
Tijhuis, M., de Jong-Gierveld, J., Feskens, J. M., & Kromhout, D. (1999). Changes in and factors related to loneliness in older men. The Zutphen Elderly Study. Age and Ageing, 28(5), 491–495. https://doi.org/10.1093/ageing/28.5.491
Vicente, F., Espirito-Santo, H., Cardoso, D., Silva, F., Costa, M., Martins, S., Torres-Pena, I., Pascoal, V., Rodrigues, F., Pinto, A., Moitinho, S., Guadalupe, S., Testa-Vicente, H., & Lemos, L. (2014). Estudo longitudinal dos fatores associados à evolução de sintomas depressivos em idosos institucionalizados [Longitudinal study of factors associated with the evolution of depressive symptoms in institutionalized elderly]. Jornal Brasileiro de Psiquiatria, 63(4), 308–316. https://doi.org/gm3r
Victor, C. R., Scambler, S. J., Bowling, A., & Bond, J. (2005). The prevalence of, and risk factors for, loneliness in later life: A survey of older people in Great Britain. Ageing and Society, 25(6), 357–375. https://doi.org/10.1017/S0144686X04003332
Victor, C. R., & Yang, K. (2012). The prevalence of loneliness among adults: A case study of the United Kingdom. The Journal of Psychology, 146(1–2), 85–104. https://doi.org/10.1080/00223980.2011.613875
Warner, D. F., Adams, S. A., & Anderson, R. K. (2019). The good, the bad, and the indifferent: Physical disability, social role configurations, and changes in loneliness among married and unmarried older adults. Journal of Aging and Health, 31(8), 1423–1453. https://doi.org/10.1177/0898264318781129
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037//0022-3514.54.6.1063
Yang, F., Zhang, J., & Wang, J. (2018). Correlates of loneliness in older adults in Shanghai, China: Does age matter? BMC Geriatrics, 18(1), 300. https://doi.org/10.1186/s12877-018-0994-x
Yang, K., & Victor, C. (2011). Age and loneliness in 25 European nations. Ageing & Society, 31(8), 1368–1388. https://doi.org/10.1017/S0144686X1000139X
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49. https://doi.org/10.1016/0022-3956(82)90033-4
Zhao, X., Zhang, D., Wu, M., Yang, Y., Xie, H., Li, Y., Jia, J., & Su, Y. (2018). Loneliness and depression symptoms among the elderly in nursing homes: A moderated mediation model of resilience and social support. Psychiatry Research, 268, 143–151. https://doi.org/10.1016/j.psychres.2018.07.011
Derechos de autor 2024 Servicio de Publicaciones, Universidad de Murcia (España)
Esta obra está bajo una licencia internacional Creative Commons Atribución-CompartirIgual 4.0.
Las obras que se publican en esta revista están sujetas a los siguientes términos:
1. El Servicio de Publicaciones de la Universidad de Murcia (la editorial) conserva los derechos patrimoniales (copyright) de las obras publicadas, y favorece y permite la reutilización de las mismas bajo la licencia de uso indicada en el punto 2.
© Servicio de Publicaciones, Universidad de Murcia, 2024
2. Las obras se publican en la edición electrónica de la revista bajo una licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (texto legal). Se pueden copiar, usar, difundir, transmitir y exponer públicamente, siempre que: i) se cite la autoría y la fuente original de su publicación (revista, editorial y URL de la obra); ii) no se usen para fines comerciales; iii) se mencione la existencia y especificaciones de esta licencia de uso.
3. Condiciones de auto-archivo. Se permite y se anima a los autores a difundir electrónicamente las versiones pre-print (versión antes de ser evaluada y enviada a la revista) y/o post-print (versión evaluada y aceptada para su publicación) de sus obras antes de su publicación, ya que favorece su circulación y difusión más temprana y con ello un posible aumento en su citación y alcance entre la comunidad académica. Color RoMEO: verde.