key: cord-1047575-8xg2fwnl
authors: Hajek, André; König, Hans‐Helmut
title: Frequency of contact with friends and relatives via internet and psychosocial factors in middle‐aged and older adults during the COVID‐19 pandemic. Findings from the German Ageing Survey
date: 2021-09-16
journal: Int J Geriatr Psychiatry
DOI: 10.1002/gps.5623
sha: cca7477b9c147f6eb24856a58d0dddbf31d94745
doc_id: 1047575
cord_uid: 8xg2fwnl

OBJECTIVES: Previous studies have examined the association between frequency of contact with friends and relatives via internet and psychosocial factors (in terms of loneliness, life satisfaction and depressive symptoms). However, far less is known about such a link during the COVID‐19 pandemic, particularly based on nationally representative samples. Therefore, the aim of this study was to examine this association among middle‐aged/older adults. METHODS/DESIGN: Data were taken from the short survey of the German Ageing Survey (June/July 2020, 3134 individuals in the analytical sample). The De Jong Gierveld scale was used to quantify loneliness, the Satisfaction with Life Scale was used to quantify life satisfaction and the 10‐item version of the Center for Epidemiological Studies‐Depression was used to quantify depressive symptoms. RESULTS: Regressions showed that—compared to daily users—less frequent users of the internet for contact with friends and relatives reported increased loneliness, lower life satisfaction and more depressive symptoms. With regard to covariates, better psychosocial factors were associated with medium education (compared to low education), living with partner in the same household (compared to singles), better self‐rated health, and favourable COVID‐19 factors (in terms of decreased feeling that the Corona crisis is a threat for oneself, not having an infection with the coronavirus and an increased feeling that you can influence an infection with the coronavirus yourself). CONCLUSIONS: Data suggest that individuals with a high frequency of contact with friends and relatives via internet reported better psychosocial factors. Future research in other cultural settings are required.

In the past few decades, contact with friends and relatives via internet (e.g., using e-mail, online social network sites such as Facebook or video telephone such as Skype) has become increasingly popular (e.g., due to increasing geographical distance to friends or relatives). While this is particularly the case among younger individuals, this is also the case for middle-aged and older adults. Since most of the individuals currently in middle age are familiar with those technical solutions to stay in contact, it is expected that the proportion of individuals in late life using such options will considerably increase in the upcoming years and decades. Moreover, in times of the COVID-19 pandemic, these technological solutions can help to stay in contact while practicing social distancing.

Thus far, a recent review 1 summarised the studies examining the association between online social media sites/video calls and loneliness among older adults based on nationally representative samples. This review concluded that the existing findings are mixed. 1 Moreover, they noted that the existing studies refer to a time period prior to COVID-19. 1 Similarly, only a few studies examined the association between contact with friends and relatives via internet and depressive symptoms as well as life satisfaction. 2 Another very recent scoping review identified positive associations between online social networking and life satisfaction, an enhanced communication with relatives and friends and decreased depressive symptoms. 2 For example, based on data from a national representative sample of older adults in the United States, a recent study showed that users of video chat (such as Skype) had a lower risk of developing depression compared to non-users. 3 Similarly, another study based on community-dwelling Medicare beneficiaries aged 65 and older in the United States showed that information and communication technologies (ICT) for different purposes can contribute to better self-rated health and a reduced likelihood of major depression. 4 A recent German study also showed that individuals who used web-connected ICT reported lower levels of loneliness among the oldest old. 5 However, these existing studies did not explicitly examine the association between contact with friends and relatives via internet and psychosocial factors and were conducted prior to the COVID-19 pandemic. During times of the COVID-19 pandemic, individuals are forced to avoid personal contact ("social distancing").

Thus, modern technologies may particularly assist in maintaining contacts with friends and relatives during these times. Therefore, the aim of this present study was to fill this gap in knowledge based on data from a nationally representative sample during the COVID-19

pandemic.

Knowledge about such associations may assist in addressing individuals at risk for adverse psychosocial outcomes. For example, a recent study provided preliminary evidence that digital mental health interventions could reduce feelings of loneliness. 6 In sum, this knowledge is important since these psychosocial factors are associated with successful ageing and mortality. [7] [8] [9] We hypothesise that regular contact with friends and relatives via internet is associated with favourable psychosocial outcomes (i.e., decreased loneliness, higher life satisfaction and fewer depressive symptoms). Such contact via internet may-at least partlycompensate for a lack of personal contact-which may be unavailable due to time or geographic restrictions or due to social distancing during times of the COVID-19 pandemic. Thus, regular users may feel less lonely than individuals with less frequent contact with friends and relatives via internet. This regular contact via internet may also assist in maintaining old friendships and stay in contact with close relatives. 2 These (online) social contacts may ultimately contribute to increased satisfaction with life and fewer depressive symptoms. 2 

Cross-sectional data was drawn from the German Ageing Survey The response rate in this wave was 56.5%-which is similar to other German survey studies. 10 Additional details with regard to the DEAS study can be found elsewhere. 11 

The De Jong Gierveld scale was used to quantify loneliness. The short version consists of six items. 12 By averaging the items, the score was computed which ranges from 1 to 4 (with higher values reflecting higher loneliness). In our current study, Cronbach's alpha was 0.79.

Favourable psychometric characteristics of this scale have been shown. 12 Life satisfaction was assessed using the Satisfaction with Life Scale (SWLS) 13 consisting of five items. By averaging the items, the final scale was calculated. It ranges from 1 to 5, with higher values corresponding to higher life satisfaction. Cronbach's alpha was 0.87 in our current study. Favourable psychometric properties of the SWLS have been shown. 13 The 10-item version of the Center for Epidemiological Studies-Depression 14 (CES-D) was used to quantify depressive symptoms.

A sum score was calculated which ranges from 0 to 30 (with higher values reflecting more depressive symptoms). Cronbach's alpha equalled 0.85 in our study. It has very good psychometric properties. 15 

Among individuals with access to the internet, the frequency of contact with friends and relatives via internet was used to quantify the key independent variable (exact wording: "Contact with friends and relatives (e.g. e-mail, Facebook, chat, video telephony like Skype)"-with the categories: never; 1 to 3 times a month; once a week; less often; several times a week; daily).

Several factors (socioeconomic factors, factors related to lifestyle, factors related to health and factors related to were included as covariates in our regression model: Age in years, sex (women; men), level of education (low education; medium education; high education; ISCED-97 classification 16 ), labour force participation (currently employed; in retirement; currently not employed), situation of living (with partner in household; with partner, but without a common household; single), one or more children (absence of a child; presence), background of migration (no; yes), income (monthly household net income in Euro), region (East Germany; West Germany), as well as type of district (rural districts; urban-rural districts; urban cities; large cities). Furthermore, frequency in physical activities and the frequency of walks was included in our regression model. In both cases, with the categories 'daily', 'several times a week', 'once a week', '1-3 times a month', 'less often' or 'never'.

Moreover, self-rated health (ranging from 1 (very good) to 5 (very bad)) was included in our regression model. Additionally, the feeling that the Corona crisis is a threat for oneself (ranging from 0 [not at all a threat for me] to 10 [extreme threat for me]), the infection with the coronavirus of people in one's own personal environment (yes; no; don't know), one's own infection with the coronavirus (yes; no; don't know), and the feeling that you can influence an infection with the coronavirus yourself (from 1 = not at all to 7 = entirely) were included in our regression model.

First, sample characteristics were calculated (stratified by the frequency of contact with friends and relatives via internet). Second, multiple linear regressions were performed to examine the association between the frequency of contact with friends and relatives via internet and social isolation and psychosocial factors.

In a robustness check, full-information maximum likelihood (FIML) was used to deal with missing values. Statistical significance was set set at p < 0.05. Stata 15.0 (Stata Corp) was used to conduct statistical analysis.

Stratified by the frequency of contact with friends and relatives via internet, sample characteristics are shown in Table 1 

Findings of multiple linear regressions are shown in Table 2 

Drawing on data from a large nationally representative sample, the aim of this study was to clarify the association between frequency of research (e.g.: [17] [18] [19] [20] Our study has some strengths. To the best of our knowledge, the current study is the first investigating the association between the use of contact with friends and relatives via internet and psychosocial factors based on a nationally representative sample of older adults during the COVID-19 pandemic. The outcome measures were quantified using well-established and widely used tools. It was adjusted for several potential confounders. However, it should be noted that the key independent variable was rather broadly quantified (contact with friends and relatives via internet). For example, it could also involve smartphone use. Furthermore, it was not distinguished between, for example, video chat and e-mail communication.

Thus, future studies with more pronounced questions are required.

Additionally, curvilinear relationships between social communication technologies and psychosocial factors could be further explored. 21 Furthermore, technology factors such as connectivity (e.g., poor/ intermittent connection vs. good quality connection) may have an impact on the association between contact with friends and relatives via internet and psychosocial outcomes. Thus, the role of technology factors in this association should be further explored. Similarly, the role of providing private care for individuals in poor health in this association could be examined in upcoming studies. Moreover, a slight sample selection bias has been identified in the DEAS study. 11 Furthermore, the possibility cannot be dismissed that the directionality is from, for example, depressive symptoms to frequency of contact with friends and relatives via internet.

In conclusion, data suggest that individuals with a high frequency of contact with friends and relatives via internet reported better psychosocial factors. Efforts related to broadband infrastructure may mitigate the impact of future pandemics on psychosocial factors.

Future research in other cultural settings is required. Moreover, the underlying reasons should be further explored. Additionally, longitudinal studies are needed to clarify the directionality.

This research received no external funding.

Open access funding enabled and organized by Projekt DEAL.

Social isolation and loneliness of older adults in times of the CoViD-19 pandemic: can use of online social media sites and video chats assist in mitigating social isolation and loneliness?

Online social networking and mental health among older adults: a scoping review

Using Skype to beat the blues: longitudinal data from a national representative sample

Older adults' technology use and its association with health and depressive symptoms: findings from the 2011 National Health and Aging Trends Study

Use of information and communication technology (ICT) devices among the oldest-old: loneliness, anomie, and autonomy

The impact of a digital intervention (Happify) on loneliness during COVID-19: qualitative focus group

Consequences of loneliness on physical activity and mortality in older adults and the power of positive emotions

Subthreshold depression and successful aging in older women

Life satisfaction and feeling in control: indicators of successful aging predict mortality in old age

Eine Non-Response-Studie [Co-operation and refusal: a non-response study

Cohort profile: the German ageing survey (DEAS)

A 6-item scale for overall, emotional, and social loneliness: confirmatory tests on survey data

Review of the satisfaction with life scale

Screening for depression in well older adults: evaluation of a short form of the CES-D

Psychometric properties of a short form of the Center for Epidemiologic Studies Depression (CES-D-10) scale for screening depressive symptoms in healthy community dwelling older adults

International Standard Classification of Education

A systematic review of longitudinal risk factors for loneliness in older adults

Subjective well-being: the science of happiness and life satisfaction

Which factors contribute to loneliness among older Europeans? Findings from the survey of health, ageing and retirement in europe: determinants of loneliness

Prevalence of depression and depressive symptoms among outpatients: a systematic review and metaanalysis

How to cite this article: Hajek A, König H-H. Frequency of contact with friends and relatives via internet and psychosocial factors in middle-aged and older adults during the COVID-19 pandemic. Findings from the German Ageing Survey

The authors declare that there is no conflict of interest.

The study was conducted in accordance with the Declaration of Helsinki. All participants provided a written consent to participate in the DEAS study. An ethics statement for the DEAS study was not needed, as the criteria for it were not met (e.g., examination of patients, risk for the respondents, or the use of invasive methods).

The anonymised data used in this study were obtained from the 'Deutsches Zentrum für Altersfragen'. Access can be obtained after application, please visit the following website for further information Access to DEAS data: Deutsches Zentrum für Altersfragen (dza.de).

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https://orcid.org/0000-0002-6886-2745