Reducing social isolation

The International Resident Assessment Instrument (interRAI), is a New Zealand-developed tool to evaluate the health and social needs of older adults that is now widely used all over the world. This evidence-based clinical assessment questionnaire that is performed on older kiwis to assess their caregiving requirements has been utilised by the Ministry for Health since 2003. The interRAIhas opened up a whole new avenue for research with hundreds of thousands of completed assessments and almost two decades worth of comprehensive data.

The Phase 1 funded cross-sectional study Risk Factors in Reduced Social Engagement utilised this wealth of data to paint a picture of how loneliness and other social factors in older people precipitated early entry into aged residential care facilities. Co-Principal Investigators Dr Sally Keeling and Associate Professor Hamish Jamieson of the University of Otago found that ethnicity and living arrangements significantly impacted loneliness; and social factors such as living alone, negative social interactions, perceived loneliness, and caregiver distress, also assisted in the progress of entering into aged residential care.

The impact of loneliness and social isolation in older cannot be underestimated. It can play a key role in health and wellbeing, with the risk of depression, anxiety, and other chronic conditions (such as pain) becoming worse. Other notable findings in the Phase 1 study included that loneliness and living arrangements differ among different ethnic groups, with a significant number of Māori acknowledging feelings of loneliness. Additionally, people living in rural areas were less likely to be lonely than those living in urban environments.

This research led to Associate Professor Jamieson  – who is also a geriatrician with the Canterbury District Health Board (CDHB) – to wonder if it is possible to identify if certain groups of people are more likely to develop poor outcomes if they are socially isolated.

About the study

Ageing Well funded the Phase 2 study Reducing Social Isolation with Big Data and it seeks to apply more sophisticated research techniques to look for patterns and possible relationships that lead to risk factors already identified in the Phase 1 project. The scope of the project was also expanded to identify any differences in patterns among Māori and other ethnic groups, and to see if the data could help researchers establish unconventional pathways and potentially modifiable early risk factors for poor outcomes. This Phase 2 research will also seek to establish why some Māori feel lonely and whether we can identify those who may be at a high risk of loneliness.

Looking to the future

As the old saying goes, prevention is better than cure. This research aims to better identify those older people in our community who are lonely and at risk of poor outcomes before they develop.

It has the potential for far-reaching impact, as the findings can be used to directly modify the care plans of the 120,000 New Zealanders who have an interRAI assessment each year. Additionally, the outcome of this research will assist in the planning and delivery of health services for all New Zealanders on a regional and national level.

The increased social integration and engagement of older people in New Zealand will help them live happier and more meaningful lives. This is particularly important for older Māori who have important roles within their whanau, hapū, iwi, and the wider community.

Links

Lifecourse Symposium 2018 (co-hosted by A Better Start, Healthier Lives, and Ageing Well National Science Challenges): a presentation by Dr Jamieson about utilising big data to help improve ageing.