title: A social model for health promotion for an aging population: Initial evidence on the experience corps model Evaluation of a Telephone-Based Support Group Intervention for Female Caregivers of Community-Dwelling Individuals With Dementia Effects of psychosocial group rehabilitation on social functioning, loneliness and well-being of lonely, older people: randomized controlled trial. Depression among nursing home elders: testing an intervention strategy. Social capital and health: Does egalitarianism matter? A literature review Effectiveness of Family Meetings for Family Caregivers on Delaying Time to Nursing Home Placement of Dementia Patients: A Randomized Trial Health promotion in older Chinese: a 12-month cluster randomized controlled trial of pedometry and "peer support". Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease Effects of Self-Management Groups for People with Dementia and Their Spouses--Randomized Controlled Trial. Social relationships and health. The psychosocial effects of a companion robot: a randomized controlled trial. Coping with dementia: evaluation of four nonpharmacologic interventions. Sustained benefit of supportive intervention for depressive symptoms in caregivers of patients with Alzheimer's disease. Volunteering: A Physical Activity Intervention for Older Adults—The Experience Corps® Program in Baltimore Social capital and health-purely a question of context? Preserving health of Alzheimer caregivers: impact of a spouse caregiver intervention. Intergenerational interaction, social capital and health: results from a randomised controlled trial in Brazil. Effects of psychosocial group rehabilitation on health, use of health care services, and mortality of older persons suffering from loneliness: a randomized, controlled trial. A prospective study of individual-level social capital and major depression in the United States Effects of a program to prevent social isolation on loneliness, depression, and subjective well-being of older adults: a randomized trial among older migrants in Japan. The Effects of a Collaborative Peer Advisor/Advanced Practice Nurse Intervention: Cardiac Rehabilitation Participation and Rehospitalization in Older Adults After a Cardiac Event Effects of socially stimulating group intervention on lonely, older people's cognition: a randomized, controlled trial. Changes in social support as mediators of the impact of a psychosocial intervention for spouse caregivers of persons with Alzheimer's disease. The impact of diabetes education and peer support upon weight and glycemic control of elderly persons with noninsulin dependent diabetes mellitus (NIDDM). A comprehensive support program: effect on depression in spouse-caregivers of AD patients. The Baltimore Experience Corps Trial: Enhancing Generativity via Intergenerational Activity Engagement in Later Life.
abstract: This report evaluates whether a program for older volunteers  , design ed for both benerativity and health promotion , leads to short-term improvements inmultiple behavioral risk factors and positive effects on intermediary risk factors for disability and other morbidities . The Experience Corps ® places  older volunteers  in public elementary schools in roles design ed to meet schools ’ needs and increase the social , physical , and cognitive activity of the volunteers . This article reports on a pilot r and omized trial in Baltimore , Maryl and . The 128 volunteers were 60–86 years old ; 95 % were African American . At follow-up of 4–8 months , physical activity , strength , people one could turn to for help , and cognitive activity increased significantly , and walking speed decreased significantly less , in participants compared to controls . In this pilot trial , physical , cognitive , and social activity increased , suggesting the potential for the Experience Corps to improve health for an aging population and simultaneously improve educational outcomes for children Family caregivers , the “ second victims ” or hidden patients in dementia care , are at risk for social isolation , stress , depression , and mortality . Telephone-based support ( telesupport groups ) represents a practical , low-burden , low-cost source of emotional support . The present study evaluated the feasibility and effectiveness of professionally led telephone-based support groups for female family caregivers of community-dwelling dementia patients . Recruited through various community sources , 103 female caregivers were r and omized to the telesupport group treatment or a control condition . Effects on caregiver burden , depression , and personal gains were evaluated at 6 months , the main end point . Older care-givers ( ≥65 ) in telesupport  reported lower depression than control group caregivers did AIM This paper is a report of a study to explore the effects of psychosocial group nursing intervention on older people 's feelings of loneliness , social activity and psychological well-being . BACKGROUND Older people 's loneliness is associated with low quality of life , and impaired health , increased use of health and social services and increased mortality . Previous intervention studies have achieved quite modest results . METHOD A r and omized controlled trial was conducted between 2003 and 2006 using a group intervention aim ed at empowering older people , and promoting peer support and social integration .  A total of 235 people ( > 74 years ) suffering from loneliness met 12 times with professional leaders in groups . The UCLA Loneliness Scale and Lubben 's Social Network Scale were used at entry , after 3 and 6 months . Psychological well-being was charted using a six-dimensional question naire at baseline and 12 months later . FINDINGS A statistically significantly larger proportion of intervention group participants had found new friends during the follow-up year ( 45 % vs. 32 % , P = 0.048 ) , and 40 % of intervention group participants continued their group meetings for 1 year . However , no differences were found in loneliness or social networks between the groups . Psychological well-being score improved statistically significantly in the intervention groups [ + 0.11 , 95 % confidence interval ( CI ) : + 0.04 to + 0.13 ] , compared with the controls ( + 0.01 , 95 % CI : -0.05 to + 0.07 , P = 0.045 ) . Feeling needed was statistically significantly more common in the intervention groups ( 66 % ) than in controls ( 49 % , P = 0.019 ) . CONCLUSION New sensitive measurements of loneliness and social isolation are needed to measure fluctuations in feelings of loneliness and in social isolation This study focused on the assessment of depression among nursing home elders , and on determining the efficacy of an intervention strategy for depression using a geropsychiatric nurse in conjunction with trained  older adult volunteers  in the role of mental health paraprofessionals .  Nursing home residents ( n = 139 ) were assessed for depression using the Geriatric Depression Scale ( GDS ) ; 94 ( 68 % ) were found to have depressive symptomatology . Among those receiving the intervention , depressive symptomatology was significantly reduced , but no significant decline was evident in the control group . The ability of the minimum data set ( MDS ) to detect depression as compared to the GDS was evaluated . Relationships between depression and health status , life satisfaction , and social support were also examined The aim of the paper is to critically review the notion of  social capital  and review empirical literature on the association between social capital and health across countries . The methodology used for the review includes a systematic search on electronic data bases for peer- review ed published literature . We categorize studies according to level of analysis ( single and multilevel ) and examine whether studies reveal a significant health impact of individual and area level social capital . We compare the study conclusions according to the country 's degrees of economic egalitarianism . Regardless of study design , our findings indicate that a positive association ( fixed effect ) exists between social capital and better health irrespective of countries degree of egalitarianism . However , we find that the between-area variance ( r and om effect ) in health tends to be lower in more egalitarian countries than in less egalitarian countries . Our tentative conclusion is that an association between social capital and health at the individual level is robust with respect to the degree of egalitarianism within a country . Area level or context ual social capital may be less salient in egalitarian countries in explaining health differences across places Background Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization . The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia . Methods A r and omized multicenter trial was conducted among 192 patients with a clinical diagnosis of dementia living at home at enrolment and their primary family caregiver . Dyads of caregivers and patients were r and omized to the  family meetings intervention  ( n = 96 ) or  usual care ( n = 96 ) condition . The intervention consisted of two individual sessions with the primary caregiver and four family counseling sessions that included family members and friends . The primary outcome measure was the time until institutionalization of the patient . Intention-to-treat as well as per protocol analyses were performed . Survival analyses were carried out to evaluate the effectiveness of the intervention . Results During 18 months follow-up 23 of 96 relatives with dementia of caregivers in the intervention group and 18 of 96 relatives with dementia of caregivers in the usual care group were institutionalized . No significant difference between the intervention and the usual care group was found in time until institutionalization ( adjusted hazard ratio ( HR ) 1.46 , 95 % confidence interval ( CI ) 0.78 to 2.74 ) . The per- protocol analysis revealed no significant effect either ( adjusted HR 0.57 , 95 % CI 0.21 to 1.57 ) , although the number of placements among the adherers was relatively low ( 9.4 % ) . A subgroup effect was found for patients ’ age , with a significantly higher risk of institutionalization for ‘ younger ’ patients in the intervention group compared with the usual care group ( adjusted HR = 4.94 , 95 % CI 1.10 to 22.13 ) . Conclusion This family meetings intervention for primary caregivers of patients with dementia did not postpone patient institutionalization more than usual care . Trial Registration : Controlled-Trials.com IS RCT PURPOSE Aging , in conjunction with decreasing physical activity , is associated with a range of health problems . Simple , low-maintenance , population -based means of promoting activity to counteract the age-associated decline are required . We therefore assessed the effect of pedometry and buddy support to increase physical activity . METHODS We undertook a clustered r and omized trial ( HKCTR-346 ) of 24 community centers involving 399 older Chinese participants ( ≥ 60 yr ) . Centers were r and omly allocated to 1 ) pedometry and buddy , 2 ) pedometry and no buddy , 3 ) no pedometry and buddy , and 4 ) no pedometry and no buddy with a 2 × 2 factorial design . The trial simultaneously tested the individual and combined effects of the interventions . The intervention groups also received monthly organized group activities to provide encouragement and support . Outcome measures were assessed at 6 and 12 months , including physical fitness and activity and cardiovascular disease risk factors ( anthropometry and blood pressure ) . RESULTS From the 24 centers , 356 volunteers ( 89.2 % ) completed the study . Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 ( 95 % confidence interval ( CI ) = 1360 - 2290 ) and 1260 ( 95 % CI = 780 - 1740 ) MET·min·wk(-1 ) , respectively relative to the decrease in the control groups . The buddy peer support intervention  significantly improved mean aerobic fitness ( 12 % [ 95 % CI = 4%-21 % ] ) and reduced both body fat ( -0.6 % [ 95 % CI = -1.1 % to 0.0 % ] ) and time to complete the 2.5-m get-up- and -go test ( -0.27 [ 95 % CI = -0.53 to -0.01 ] s ) . No other improvements in the cardiovascular disease risk factors were observed . The combination of motivational tools was no better than the individual interventions . CONCLUSIONS Both motivational interventions increased physical activity levels , and the buddy style improved fitness . These tools could be useful adjuncts in the prevention of obesity and age-related complications Objective : To determine the effectiveness of a counseling and support intervention for spouse caregivers in delaying time to nursing home placement of patients with Alzheimer disease ( AD ) , and identify the mechanisms through which the intervention accomplished this goal . Methods : We conducted a r and omized controlled trial of an enhanced counseling and support intervention compared to usual care . Participants were a referred volunteer sample of 406 spouse caregivers of community-dwelling patients who had enrolled in the study over a 9.5-year period . The intervention consisted of six sessions of individual and family counseling , support group participation , and continuous availability of ad hoc telephone counseling . Structured question naires were administered at baseline and at regular follow-up intervals , every 4 months for the first year and every 6 months thereafter . Cox proportional hazard models were used to test the effects of the intervention on the time to nursing home placement for the patients after controlling for multiple time-invariant and time-dependent predictors of placement . Results : Patients whose spouses received the intervention experienced a 28.3 % reduction in the rate of nursing home placement compared with usual care controls ( hazard ratio = 0.717 after covariate adjustment , p = 0.025 ) . The difference in model-predicted median time to placement was 557 days . Improvements in caregivers ’ satisfaction with social support , response to patient behavior problems , and symptoms of depression collectively accounted for 61.2 % of the intervention ’s beneficial impact on placement . Conclusion : Greater access to effective programs of counseling and support could yield considerable benefits for caregivers , patients with Alzheimer disease , and society OBJECTIVES To investigate the effect of self-management group rehabilitation for persons with dementia ( PwD ) and their spouses on their health-related quality of life ( HRQoL ) , the cognition of the PwD , and the costs of health and social services . DESIGN A r and omized controlled trial . SETTING Primary care and memory clinics in the Helsinki metropolitan area , Finl and . PARTICIPANTS PwD ( N = 136 ) and their spouses ( N = 136 ) . INTERVENTION Couples were r and omized to usual care or eight-session self-management groups for PwD and concurrently for their spouses . Sessions aim to enhance self-efficacy and problem-solving skills and to provide peer support . MEASUREMENTS The primary outcome measures were the HRQoL of PwD ( measured using a generic , comprehensive ( 15-dimensional ) , self-administered instrument ( 15D ) ) and spouses ( measured using the R AND -36 ) and the spousal Sense of Competence Question naire ( SCQ ) . Secondary outcome measures were PwD cognition ( Verbal Fluency ( VF ) , Clock Drawing Test ( CDT ) ) and costs of health and social services during 24 months . RESULTS At 3 months , the spouse physical component of the R AND -36 improved ( mean change 1.0 , 95 % confidence interval ( CI ) = -0.5 to 2.4 ) for those undergoing the intervention and worsened for controls ( mean change -2.0 , 95 % CI = -3.5 to -0.4 ) ( P = .006 adjusted for age , sex , baseline value of the physical component of the R AND -36 ) . There were no differences between the groups on the mental component of the R AND -36 , the SCQ , or the 15D . At 9 months , PwD change in VF was -0.38 ( 95 % CI = -1.03 to 0.27 ) in intervention group and -1.60 ( 95 % CI = -2.26 to -0.94 ) for controls ( P = .011 adjusted for age , sex , baseline MMSE score ) . CDT changes were similar to VF changes . Differences in incremental costs between the groups was -436 € per person per year ( 95 % CI = -4,986 to 4,115 ) for PwD ( P = .35 adjusted for age , CDR ) and -896 € per person per year ( 95 % CI = -3,657 to 1,864 ) for spouses ( P = .51 adjusted for PwD age , CDR ) . CONCLUSIONS The intervention had beneficial effects on the HRQoL of spouses and the cognitive function of PwD without increasing total costs . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12611001173987 Recent scientific work has established both a theoretical basis and strong empirical evidence for a causal impact of social relationships on health . Prospect i ve studies , which control for baseline health status , consistently show increased risk of death among persons with a low quantity , and sometimes low quality , of social relationships . Experimental and quasi-experimental studies of humans and animals also suggest that social isolation is a major risk factor for mortality from widely varying causes . The mechanisms through which social relationships affect health and the factors that promote or inhibit the development and maintenance of social relationships remain to be explored OBJECTIVES To investigate the psychosocial effects of the companion robot , Paro , in a rest home/hospital setting in comparison to a control group . DESIGN R and omized controlled trial . Residents were r and omized to the robot intervention group or a control group that attended normal activities instead of Paro sessions . Sessions took place twice a week for an hour over 12 weeks . Over the trial period , observations were conducted of residents ' social behavior when interacting as a group with the robot . As a comparison , observations were also conducted of all the residents during general activities when the resident dog was or was not present . SETTING A residential care facility in Auckl and , New Zeal and . PARTICIPANTS Forty residents in hospital and rest home care . MEASUREMENTS Residents completed a baseline measure assessing cognitive status , loneliness , depression , and quality of life . At follow-up , residents completed a question naire assessing loneliness , depression , and quality of life . During observations , behavior was noted and collated for instances of talking and stroking the dog/robot . RESULTS In comparison with the control group , residents who interacted with the robot had significant decreases in loneliness over the period of the trial . Both the resident dog and the seal robot made an impact on the social environment in comparison to when neither was present . Residents talked to and touched the robot significantly more than the resident dog . A greater number of residents were involved in discussion about the robot in comparison with the resident dog and conversation about the robot occurred more . CONCLUSION Paro is a positive addition to this environment and has benefits for older people in nursing home care .  Paro may be able to address some of the unmet needs of older people that a resident animal may not , particularly relating to loneliness To evaluate nonpharmacologic interventions , caregivers ( 65 women , 38 men ) and their dementia-diagnosed spouses ( patients ) were r and omized to one of four treatment programs ( cognitive stimulation , dyadic counseling , dual supportive seminar , and early-stage day care ) or to a wait-list control group . Assessment s occurred initially and at postintervention ( 3 months ) . Patients were evaluated on memory , verbal fluency , and problem-solving ability , and caregivers were assessed on marital interaction , emotional status , and physical health , along with stress , coping , and social support .  Caregivers also completed a program evaluation . Repeated measures procedures showed that patients in the cognitive stimulation group demonstrated more improvement over time in cognitive outcomes , and caregivers decreased in depressive symptoms . Early-stage day-care and dual supportive seminar group caregivers reported a decrease in hostility and a decrease in use of negative coping strategies , respectively . Although qualitatively derived benefits differed across groups , similarities in program content reduced the potential for quantitative differentiation among the groups OBJECTIVE The long-term effect of counseling and support on symptoms of depression was examined in spouse-caregivers of patients with Alzheimer 's disease . METHOD The participants were 406 spouse-caregivers of Alzheimer 's disease patients who lived at home at baseline . The caregivers were r and omly assigned to either a group receiving enhanced counseling and support treatment or a group receiving usual care ( control group ) . Caregivers in the enhanced treatment group were provided with six sessions of individual and family counseling , agreed to join support groups 4 months after enrollment , and received ongoing ad hoc counseling . The Geriatric Depression Scale was administered at baseline and at regular follow-up intervals for as long as the caregiver participated in the study . RESULTS After baseline differences were controlled for , caregivers in the enhanced treatment group had significantly fewer depressive symptoms after the intervention than did the control subjects . These effects were sustained for 3.1 years after baseline , similar across gender and patient severity level , and sustained after nursing home placement or death of the patient . CONCLUSIONS Counseling and support lead to sustained benefits in reducing depressive symptoms in spouse-caregivers of Alzheimer 's disease patients and should be widely available to provide effective , evidence -based intervention for family caregivers There is compelling evidence supporting the benefits of increased regular physical activity in older adults . The Experience Corps program in Baltimore MD was design ed in part as a community based approach to increasing physical activity that would also appeal to older adults who have historically not utilized health promotion programs . The Baltimore Experience Corps program places older volunteers in public elementary schools for 15 h a week in roles design ed to improve the academic outcomes of children and , simultaneously , increase the physical , cognitive and social activity of volunteers . This paper reports on the change in physical activity levels among older adults associated with participation in the Baltimore Experience Corps . In a pilot r and omized controlled evaluation , older adults were r and omly assigned to  Experience Corps ( EC participants ) or a waiting list control group . Ages ranged from 59–86 years , 96 % were African American , 94 % were women , and 84 % had annual incomes less than $ 15,000 . EC participants were required to serve ≥15 h a week . At follow-up after 4–8 months , an analysis of 113 r and omized volunteers revealed 53 % of the EC participants were more  active than the previous year by self-report , as compared to 23 % of the controls ( p<0.01 ) . When adjusted for age , gender and education , there was a trend toward increased physical activity in the EC participants as calculated by a kilocalorie per week increase of 40 % , versus a 16 % decrease in the controls ( p=0.49 ) . EC participants who reported “ low activity ” at baseline experienced an average 110 % increase in their physical activity at follow-up . Among the controls who were in the “ low activity ” group at baseline , there was , on average , only a 12 % increase in physical activity ( p=0.03 ) . Among those who were previously active , there was no significant difference ( p=0.30 ) . The pilot results suggest that a high intensity volunteer program that is design ed as a health promotion intervention can lead , in the short-term , to significant improvements in the level of physical activity of previously inactive older adult volunteers Debate still surrounds which level of analysis ( individual vs. context ual ) is most appropriate to investigate the effects of social capital on health . Applying multilevel ecometric analyses to British Household Panel Survey data , we estimated fixed and r and om effects between five individual- , household- and small area-level social capital indicators and general health . We further compared the variance in health attributable to each level using intraclass correlations . Our results demonstrate that association between social capital and health depends on indicator type and level investigated , with one quarter of total individual-level health variance found at the household level . However , individual-level social capital variables and other health determinants appear to influence context ual-level variance the most OBJECTIVE The objective of this study was to determine the effects of counseling and support on the physical health of caregivers of spouses of people with Alzheimer disease . METHODS A r and omized controlled trial , conducted between 1987 and 2006 at an outpatient research clinic in the New York City metropolitan area compared outcomes of psychosocial intervention to usual care . Structured question naires were administered at baseline and regular follow-ups . A referred volunteer sample of 406 spouse caregivers of community dwelling patients with Alzheimer disease enrolled over a 9.5-year period .  Enhanced counseling and support consisted of six sessions of individual and family counseling , support group participation , and continuous availability of ad-hoc telephone counseling . Indicators of physical health included self-rated health ( SRH ) of caregivers and the number of reported illnesses . RESULTS Controlling for baseline SRH ( mean : 7.24 ) , intervention group caregivers had significantly better SRH than control group caregivers based upon model predicted mean scores four months after baseline ( 6.87 versus 7.21 ) , and this significant difference was maintained for two years ( 6.70 versus 7.01 ) . The effect of the intervention on SRH remained significant after controlling for the effects of patient death , nursing home placement , caregiver depressive symptoms and social support satisfaction . Similar benefits of intervention were found for number of illnesses .  CONCLUSION Counseling and support preserved SRH in vulnerable caregivers . Enhancing caregivers ' social support , fostering more benign appraisal s of stressors , and reducing depressive symptoms may yield indirect health benefits . Psychosocial intervention studies with biological measures of physical health outcomes are warranted Recent years have seen a burgeoning of intergenerational programmes aim ing to improve the well being of participants . However , very few programmes have been formally evaluated . In this paper we report results from a r and omised controlled trial of a school-based intergenerational intervention undertaken in Brazil . R and omly selected sample s of 253 adolescents and 266 elders aged 60 and over resident in the school 's catchment area were administered a question naire including questions on cognitive components of social capital , family relationships , and self-rated health . Participants were then r and omly allocated to control and intervention groups . The intervention comprised participation in a 4 month programme of intergenerational activities in which the elders shared their memories with the students . At the end of the intervention the question naire was re-administered to the sample s. High proportions ( 85 - 95 % ) of both sample s completed the question naires but compliance with the intervention was low in the elderly group . In the analysis of results from the elderly sample , we therefore compared the control group with the group assigned to the intervention ( intention to treat analysis ) . Results showed that adolescents in the intervention group were nearly three times more likely to rate their health as good than those in the control group , but also more likely to judge that most people were selfish . In the elderly sample , those from the intervention group were over twice as likely as those from the control group to report positively on the helpfulness of neighbours ; judge most people to be honest or consider their family relationships as good . There were no significant differences between groups on other outcome measures . These results suggest that structured intergenerational activities may have positive effects on some aspects of social capital for both adolescents and elderly people , although further research is needed to eluci date the processes involved and the extent to which the findings are context specific . This study is the first to use a controlled trial design to evaluate this type of intervention and is valuable in showing that this design can be used in interventions of this kind , and also the difficulties involved BACKGROUND Loneliness is a distressing feeling of a lack of satisfying human relationships . It is associated with poor quality of life , impaired health , and increased mortality among older individuals . The study aim was to determine the effects of new psychosocial group rehabilitation on the subjective health , use and costs of health services , and mortality of lonely older individuals . METHODS This r and omized , controlled trial was performed in seven day care centers . A total of 235 older people ( > 74 years ) suffering from loneliness participated . Intervention was implemented in 15 groups ( each with 7 - 8 participants and 2 professional group leaders ) meeting for 3 months altogether 12 times . Group intervention aim ed to empower elderly people , and to promote their peer support and social integration . Intervention was based on the effects of closed-group dynamics . The groups had the following activities according to the participants ' interests : ( a ) therapeutic writing and group psychotherapy , ( b ) group exercise and discussion s , and ( c ) art activities . Group leaders received thorough training and tutoring .  Subjective health , use and costs of health services , and mortality were measured . RESULTS At 2 years , survival was 97 % in the intervention group ( 95 % confidence interval [ CI ] , 91 - 99 ) and 90 % in the control group ( 95 % CI , 85 - 95 ) ( p = .047 ) . The intervention group showed a significant improvement in subjective health , thus result ing in significantly lower health care costs during the follow-up : the difference between the groups was -943 euro/person per y ( 95 % CI -1955 to -127 ; p = .039 ) . CONCLUSIONS Psychosocial group rehabilitation was associated with lower mortality and less use of health services Study objective : To investigate prospect ively the associations between depression and cognitive social capital ( social trust , sense of belonging , mutual aid ) and structural social capital ( volunteer work and community participation ) . Methods : This was a prospect i ve study that was carried out in the USA . The participants were a nationally representative sample of 724 English-speaking non-institutionalised adults ( 25–74 years old ) who participated in the National Survey of Midlife Development in the United States ( MIDUS ) in 1995–6 and the MIDUS Psychological Experience Follow-Up study in 1998 . Main results : In multivariable adjusted logistic regression analyses , those who trusted their neighbours were less likely to develop major depression ( MD ) during follow-up than those who reported low levels of social capital on these dimensions ( adjusted OR of MD for high vs low trust = 0.43 ; 95 % CI 0.20 to 0.93 , adjusted for MD at baseline , age , gender , race , education , working status , marital status , physical health and extroversion traits ) . Structural dimensions of social capital were not associated with MD in adjusted models . Conclusions : Perceptions of higher levels of cognitive social capital ( trust of neighbours ) are associated with lower risks of developing MD during 2–3 year follow-up . However , after excluding participants with MD at the baseline , the association between trust and MD became non-significant . Structural dimensions were not associated with MD Social isolation among the elderly is a concern in developed countries . Using a r and omized trial , this study examined the effect of a social isolation prevention program on loneliness , depression , and subjective well-being of the elderly in Japan . Among the elderly people who relocated to suburban Tokyo , 63 who responded to a pre-test were r and omized and assessed 1 and 6 months after the program . Four sessions of a group-based program were design ed to prevent social isolation by improving community knowledge and networking with other participants and community " gatekeepers . " The Life Satisfaction Index A ( LSI-A ) , Geriatric Depression Scale ( GDS ) , And o-Osada-Kodama ( AOK ) loneliness scale , social support , and other variables were used as outcomes of this study . A linear mixed model was used to compare 20 of the 21 people in the intervention group to 40 of the 42 in the control group , and showed that the intervention program had a significant positive effect on LSI-A , social support , and familiarity with services scores and a significant negative effect on AOK over the study period . The program had no significant effect on depression . The findings of this study suggest that programs aim ed at preventing social isolation are effective when they utilize existing community re sources , are tailor-made based on the specific needs of the individual , and target people who can share similar experiences Background : After the cardiovascular events of myocardial infa rct ion ( MI ) and coronary artery bypass surgery ( CABS ) , unpartnered older adults are a vulnerable group that may benefit from interventions to improve health outcomes . The purpose of this analysis is to determine if a community-based collaborative peer advisor/advanced practice nurse intervention increased participation in cardiac rehabilitation programs and reduced hospital readmissions after MI and CABS and determine whether the type of cardiovascular event influenced rehospitalization . Subjects and Methods : This study was a r and omized clinical trial that enrolled 247 unpartnered older adults who were single , widowed , or divorced . Subjects were r and omized into 4 groups : st and ard of care group for MI and for CABS and st and ard of care plus the treatment groups for MI and for CABS , for 12 weeks after discharge . There were 163 women/84 men , with a mean age of 76.4 years , who were admitted for MI ( n = 93 ) or CABS ( n = 154 ) and who were enrolled from 5 academic medical centers . The treatment consisted of a community-based intervention of a home visit within 72 hours and telephone calls at 2 , 6 , and 10 weeks from an advanced practice nurse and 12 weekly telephone calls from a peer advisor .  Participation in a cardiac rehabilitation program and rehospitalizations were collected at 6 weeks and 3 , 6 , and 12 months by telephone interview . Results and Conclusions : There were significantly more participants in cardiac rehabilitation programs after 3 months in the treatment group , and this increase was seen up to 1 year after MI and CABS . There were no statistical differences , although there were fewer rehospitalizations between 3 and 6 months after MI and CABS in the treatment group compared with the st and ard of care group . Overall , the evidence from this study suggests that a community-based collaborative peer advisor/advanced practice nurse intervention can play a role in promoting active participation in cardiac rehabilitation programs and fewer rehospitalizations in unpartnered older adults after MI and CAGS OBJECTIVE Loneliness may predict impaired cognition among older people . The aim of this study was to determine the effects of socially stimulating group intervention on cognition among older individuals suffering from loneliness . DESIGN A r and omized controlled trial . SETTING AND PARTICIPANTS Two hundred thirty-five participants ( ≥75 years ) in seven day care centers in Finl and . INTERVENTION Group intervention was based on the effects of closed-group dynamics and peer support . The three-month intervention was aim ed to enhance interaction and friendships between participants and to socially stimulate them . Each group was facilitated by two specifically trained professionals . In addition to active discussion s , the groups included three types of activities depending on the participants ' interests : 1 ) therapeutic writing ; 2 ) group exercise ; and 3 ) art experiences .  MEASUREMENTS Cognition was measured by the Alzheimer 's Disease Assessment Scale ( ADAS-Cog ) , and mental function was measured by the 15D measure . RESULTS The intervention and control groups were similar at baseline with respect to their demographics , disease burden , depression , and cognition . The ADAS-Cog scale improved more in the intervention group than in the control group within the three-month period , with mean changes being -2.6 points ( 95 % confidence interval [ CI ] : -3.4 to -1.8 ) and -1.6 points ( 95 % CI : -2.2 to -1.0 ) , respectively . The dimension of mental function in the 15D showed significant improvement at 12 months in the intervention group ( + 0.048 , 95 % CI : + 0.013 to + 0.085 ) compared with the control group ( -0.027 , 95 % CI : -0.063 to + 0.010 ) . CONCLUSION Psychosocial group intervention improved lonely older people 's cognition The spouse caregivers of 406 patients with Alzheimer 's disease were r and omly assigned to an enhanced counseling and support intervention or to a usual care control condition . Structured interviews were conducted to assess changes in social support and psychosocial outcomes for the 312 caregivers who provided care in the home for at least 1 year . The number of support persons , satisfaction with the support network , and support persons ' assistance with caregiving all increased significantly as a function of the intervention . Structural equation models indicated increased satisfaction with the social support network mediated a significant proportion of the intervention 's impact on caregiver depression . A portion of this mediated effect was further mediated by changes in caregiver stress appraisal s. Implication s for strengthening intervention programs for spouse caregivers of individuals with Alzheimer 's disease are discussed We assessed diabetes education and peer support interventions as facilitators of weight loss and glycemic control in a community sample of 79 elderly persons with noninsulin-dependent diabetes mellitus ( NIDDM ) . Different groups received : education only , education and peer support , and no treatment .  Peer support was higher in groups where it was actively facilitated . Weight loss and reduction in level of glycemic control occurred within groups receiving both diabetes education and peer support Caregivers of Alzheimer 's disease patients often suffer from depression . Using a longitudinal treatment/control study , we examined the effects of a comprehensive support program on  depression in spouse-caregivers . This psychosocial intervention program treats the primary caregiver and family members over the entire course of the disease through individual and family counseling , the continuous availability of ad hoc counseling , and support group participation . In the first year after intake , the control group became increasingly more depressed , whereas the treatment group remained stable . By the eighth month , treated caregivers were significantly less depressed than those in the control group . These results suggest that enhancing long-term social support can have a significant impact on depression in caregivers OBJECTIVES Being and feeling generative , defined as exhibiting concern and behavior to benefit others , is an important developmental goal of midlife and beyond . Although a growing body of evidence suggests mental and physical health benefits of feeling generative in later life , little information exists as to the modifiability of generativity perceptions . The present study examines whether participation in the intergenerational civic engagement program , Experience Corps ( EC ) , benefits older adults '  self-perceptions of generativity . METHOD Levels of generativity were compared in older adults r and omized to serve as EC volunteers or controls ( usual volunteer opportunities ) in the Baltimore Experience Corps Trial at 4- , 12- , and 24-month evaluation points over the 2-year trial . Analyses utilized intention-to-treat and complier average causal effects ( CACE ) analyses which incorporate degree of intervention exposure in analytic models . RESULTS Participants r and omized to the EC group had significantly higher levels of generative desire and perceptions of generative achievement than controls at each follow-up point ; CACE analyses indicate a dose-response effect with a greater magnitude of intervention effect with greater exposure to the EC program . DISCUSSION Results provide the first-ever , large-scale experimental demonstration that participation in an intergenerational civic engagement program can positively alter self-perceptions of generativity in older adulthood
target: According to sufficiently reported outcomes , social capital interventions showed mixed effects on quality of life , well-being and self-perceived health and were generally ineffective on loneliness , mood and mortality .
  Conclusions Our review highlights the lack of evidence and the diversity among trials , while supporting the potential of social capital interventions to reach comprehensive health effects in older adults
background: Background Observational studies show that social capital is a protective health factor .
  Therefore , we aim to assess the currently unclear health impact of social capital interventions targeting older adults .