LitCovid-sentences  

PMC:7796152 / 1689-27515 JSONTXT 3 Projects

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Id Subject Object Predicate Lexical cue
T15 0-2 Sentence denotes 1.
T16 3-15 Sentence denotes Introduction
T17 17-21 Sentence denotes 1.1.
T18 22-52 Sentence denotes Subjective Age of Older Adults
T19 53-160 Sentence denotes Subjective age refers to the degree to which people feel younger or older than their chronological age [1].
T20 161-255 Sentence denotes Like chronological age, subjective age contributes to a variety of developmental outcomes [2].
T21 256-382 Sentence denotes People who feel younger than their chronological age are usually better off than those who feel their actual age or older [3].
T22 383-668 Sentence denotes For instance, the outcomes of one of the only meta-analyses that has investigated the longitudinal effect of subjective age on future health and longevity among adults (average age 57–85 years) revealed that feeling younger is connected with improved physical health and longevity [4].
T23 669-904 Sentence denotes Furthermore, a correlation has been found between younger subjective age and important developmental processes, such as enhanced subjective wellbeing [5], better cognition test performance [6], and having fewer depressive symptoms [7].
T24 905-1101 Sentence denotes Research has found that feeling younger than one’s chronological age is associated with higher levels of subjective wellbeing [5], greater life satisfaction [8,9], and more positive affect [5,10].
T25 1102-1241 Sentence denotes Younger subjective age is also associated with having a sense of meaning in life, higher levels of optimism, and more successful aging [8].
T26 1242-1399 Sentence denotes Similarly, feeling younger correlates with a decreased likelihood of experiencing a major episode of depression [11] and reduced symptoms of depression [12].
T27 1400-1504 Sentence denotes In another meta-analysis, women reported a younger subjective age compared to that reported by men [13].
T28 1505-1680 Sentence denotes Later studies have provided more evidence that being a woman is correlated with younger subjective age [5,14,15]; however, others have not found this correlation [6,16,17,18].
T29 1681-1917 Sentence denotes The impact of loneliness on subjective age is not clear; one study found that a decrease in loneliness resulted in a decrease in subjective age, but, changes in objective social indicators did not predict changes in subjective age [19].
T30 1919-1923 Sentence denotes 1.2.
T31 1924-1950 Sentence denotes Loneliness in Older Adults
T32 1951-2048 Sentence denotes The definition of loneliness is the gap between real and wished for social relationships [20,21].
T33 2049-2158 Sentence denotes Similar to subjective age, loneliness is a subjective concept and not an objective social manifestation [20].
T34 2159-2414 Sentence denotes Although loneliness can be connected with objective aspects of the social network including the number and frequency of actual social contacts, it is not synonymous with these aspects and it still represents the qualitative elements of relationships [22].
T35 2415-2563 Sentence denotes With a few exceptions, the majority of past research has emphasized the role of loneliness as a strong predictor of morbidity and mortality [23,24].
T36 2564-2807 Sentence denotes A considerable body of research has pointed out that a high level of loneliness is a major risk factor for cardiovascular diseases [25], disability [26], poor sleep hygiene [27], impaired cognition [28], and impaired physical functioning [22].
T37 2808-3162 Sentence denotes These negative effects of loneliness might explain the possible association between feelings of loneliness and subjective age, and in contrast, the negative correlation between size of friendship network and self-perception of age (for example, the finding that women who felt themselves younger than their actual age had larger friendship networks [29].
T38 3163-3380 Sentence denotes Moreover, a recent study suggested a plausible causal model of loneliness leading to morbidity and mortality, and found evidence of mediation by subjective health, depressive symptoms, and functional limitations [30].
T39 3381-3570 Sentence denotes Although objective indicators of social relationships also predict health and well-being [31,32], these are generally thought to exert a somewhat smaller effect in comparison to loneliness.
T40 3571-3664 Sentence denotes However, there is general consent that loneliness increases with age among older adults [33].
T41 3665-3757 Sentence denotes This is not surprising given the many objective losses that take place in advanced age [33].
T42 3758-3989 Sentence denotes Objective losses include, for example, retirement because it is often associated with the narrowing of one’s social network or the death of a spouse, siblings, and close friends, which also result in reduced social contact [34,35].
T43 3991-3995 Sentence denotes 1.3.
T44 3996-4013 Sentence denotes Mediating Factors
T45 4014-4352 Sentence denotes In addition to the possible direct correlation between loneliness and subjective age, during a crisis like the Coronavirus disease (COVID-19) pandemic, feelings of loneliness can have far-reaching implications for the life of older adults, which could shed light on some of the effects of feeling lonely on subjective age during a crisis.
T46 4353-4438 Sentence denotes Two specific mediators are likely to be at play—depressive symptoms and malnutrition.
T47 4440-4446 Sentence denotes 1.3.1.
T48 4447-4466 Sentence denotes Depressive Symptoms
T49 4467-4663 Sentence denotes According to the 2001 World Health Organization (WHO) Global Burden of Disease Study, depression is a serious public health problem among individuals, families, and societies throughout the world.
T50 4664-4825 Sentence denotes The WHO estimated that depression was the fourth leading contributor to the global burden of disease in 2000, as measured by disability-adjusted life years [36].
T51 4826-5051 Sentence denotes Although depression rates are generally lower among older adults (5.4%) compared to middle-aged (9.8%) and younger (7.4%) adults, the rate among seniors in the United States has continued to rise in recent decades [37,38,39].
T52 5052-5154 Sentence denotes In addition, the reported rates of depression in the older population of the US may be underestimated.
T53 5155-5392 Sentence denotes This is because depressive symptoms can be masked as physical complaints or initially appear to be cognitive impairments in this age group, moreover, the stigma of mental illness may inhibit depressed older adults from seeking treatment.
T54 5393-5523 Sentence denotes Depression is one of the negative health outcomes linked to loneliness as well as disability, and cognitive decline [40,41,42,43].
T55 5524-5681 Sentence denotes For example, a study in Ohio retirement communities found that older individuals who reported feeling lonely had significantly higher depression scores [44].
T56 5682-5755 Sentence denotes However, the experiences and consequences of loneliness may vary greatly.
T57 5756-5883 Sentence denotes Moreover, because subjective age reflects self-perception, it is also related to many psychological factors among older adults.
T58 5884-6035 Sentence denotes Research has shown that people who feel younger than their chronological age tend to be mentally healthy and have fewer psychological problems [11,12].
T59 6036-6184 Sentence denotes In addition, younger subjective age has been associated with less stress [1], fewer depressive symptoms [45,46], and strong mastery beliefs [45,47].
T60 6186-6192 Sentence denotes 1.3.2.
T61 6193-6205 Sentence denotes Malnutrition
T62 6206-6457 Sentence denotes Malnutrition is defined as a state in which a deficiency, excess, or imbalance of energy, protein, and other nutrients causes measurable adverse effects on tissue and body form (body shape, size, and composition), function, and clinical outcomes [48].
T63 6458-6507 Sentence denotes It is more prevalent as age increases [49,50,51].
T64 6508-6693 Sentence denotes The etiology of malnutrition is multifactorial; adverse physiological, psychological, and social causes of malnutrition in older adults are consistently reported in the literature [52].
T65 6694-6974 Sentence denotes Aging is accompanied by physiological changes that can negatively impact nutritional status, for example, sensory impairment may result in reduced appetite and poor oral health, and dental problems can lead to difficulty chewing, inflammation, and a monotonous, poor-quality diet.
T66 6975-7104 Sentence denotes Progressive loss of vision and hearing may also limit mobility and affect the ability to shop for food and prepare meals [53,54].
T67 7105-7426 Sentence denotes In addition to loneliness and depression, other psychosocial and social changes characteristic of older adults, such as cognitive impairment, heavy use of medication, periods of lengthy hospitalization, retirement from paid work, bereavement, and increasing frailty can also contribute to poor nutritional status [54,55].
T68 7427-7621 Sentence denotes These factors affect the ability of older adults to meet dietary needs or to digest, absorb, utilize, or excrete nutrients that are ingested, leading to reduced energy intake and lean body mass.
T69 7622-7773 Sentence denotes This, in turn, may result in a reduced metabolic rate, a corresponding decline in total energy expenditure, and potentially to malnutrition [56,57,58].
T70 7774-7884 Sentence denotes Thus, malnutrition, like other unhealthy outcomes of old age, may also be associated with subjective age [45].
T71 7886-7888 Sentence denotes 2.
T72 7889-7906 Sentence denotes The Current Study
T73 7907-8018 Sentence denotes In response to the COVID-19 pandemic that began in 2019, a policy of social distancing was initiated worldwide.
T74 8019-8142 Sentence denotes Although circumstances necessitate such extreme measures, social isolation presents a risk for adverse health effects [59].
T75 8143-8388 Sentence denotes Older adults who are at greater risk for COVID-19 health complications are likely to remain in strict self-isolation longer than other age groups; therefore, the effects of isolation and ensuing loneliness may be especially severe for them [60].
T76 8389-8509 Sentence denotes Loneliness reflects subjective distress resulting from a discrepancy between desired and perceived social relationships.
T77 8510-8726 Sentence denotes Unfortunately, it causes a host of poor outcomes, such as depression, anxiety, physical morbidity, and mortality, and might also correlate with older subjective age, which is associated with further health risks [4].
T78 8727-8858 Sentence denotes The current study assessed the status of feelings of loneliness and subjective age among older adults during the COVID-19 pandemic.
T79 8859-9022 Sentence denotes We identified the factors underlying the association between the two and explored the role of two potential mediating factors—depressive symptoms and malnutrition.
T80 9023-9107 Sentence denotes The study also explored how subjective age is changing during the COVID-19 pandemic.
T81 9108-9275 Sentence denotes In light of the literature reviewed, we posited three hypotheses:In comparison with the period before the pandemic, older adults feel older in age during the pandemic.
T82 9276-9357 Sentence denotes Feelings of loneliness are associated with subjective age during times of crisis.
T83 9358-9615 Sentence denotes Feelings of loneliness are indirectly associated with subjective age during crises through depressive symptoms and malnutrition; lonely older adults feel older during crises, and this is associated with higher levels of depressive symptoms and malnutrition.
T84 9617-9619 Sentence denotes 3.
T85 9620-9626 Sentence denotes Method
T86 9628-9632 Sentence denotes 3.1.
T87 9633-9662 Sentence denotes Study Design and Participants
T88 9663-9832 Sentence denotes This was a cross-sectional study of a convenience sample of 201 older adults aged 65 and over, who represent the two main ethnic groups living in Israel, Jews and Arabs.
T89 9833-9957 Sentence denotes Inclusion criteria were age 65 and over and the ability to speak and understand (but not necessarily read) Hebrew or Arabic.
T90 9958-9990 Sentence denotes The refusal rate was 21 percent.
T91 9992-9996 Sentence denotes 3.2.
T92 9997-10007 Sentence denotes Procedures
T93 10008-10105 Sentence denotes The Research Ethics Committee of the college at which the research took place approved the study.
T94 10106-10234 Sentence denotes Those who agreed to participate received an explanation about the study and their right to withdraw at any time without penalty.
T95 10235-10273 Sentence denotes Strict confidentiality was maintained.
T96 10274-10466 Sentence denotes Professional interviewers collected the data in telephone interviews (in compliance with pandemic-related restrictions), using appropriate translated, validated, and structured questionnaires.
T97 10467-10508 Sentence denotes The participants were recruited randomly.
T98 10509-10553 Sentence denotes The final sample comprised 201 participants:
T99 10554-10577 Sentence denotes 100 Jews and 101 Arabs.
T100 10578-10624 Sentence denotes The data were collected in April and May 2020.
T101 10626-10630 Sentence denotes 3.3.
T102 10631-10639 Sentence denotes Measures
T103 10641-10647 Sentence denotes 3.3.1.
T104 10648-10669 Sentence denotes Independent Variable:
T105 10670-10680 Sentence denotes Loneliness
T106 10681-10817 Sentence denotes Loneliness was measured by a single direct question: “Do you sometimes feel lonely?” with four options: never, seldom, sometimes, often.
T107 10819-10825 Sentence denotes 3.3.2.
T108 10826-10845 Sentence denotes Dependent Variable:
T109 10846-10901 Sentence denotes Subjective Age during a Crisis (the COVID-19 Pandemic).
T110 10902-11107 Sentence denotes Subjective age was measured by two direct questions: “On a scale from 0 to 5, how old do you feel?” The six options were on a scale between 0 = younger than my actual age, and 5 = older than my actual age.
T111 11108-11219 Sentence denotes The participants were asked to refer to the time before the COVID-19 pandemic and the time during the pandemic.
T112 11221-11225 Sentence denotes 3.4.
T113 11226-11235 Sentence denotes Mediators
T114 11237-11243 Sentence denotes 3.4.1.
T115 11244-11263 Sentence denotes Depressive Symptoms
T116 11264-11348 Sentence denotes Depressive symptoms were measured using the GDS (Geriatrics Depression Scale; [61]).
T117 11349-11535 Sentence denotes This questionnaire was chosen because it is a simple and reliable tool that allows the examination of depressive symptoms among older adults without requiring a professional interviewer.
T118 11536-11611 Sentence denotes The instrument is composed of 15 items in a yes (1)/no (2) response format.
T119 11612-11665 Sentence denotes The internal reliability (Cronbach’s alpha) was 0.80.
T120 11667-11673 Sentence denotes 3.4.2.
T121 11674-11686 Sentence denotes Malnutrition
T122 11687-11955 Sentence denotes Malnutrition was measured using the NSI (Determine Nutrition Screening Initiative) instrument, developed by the American Diabetes Association, the American Family Doctors Association, and the National Council of Old Age to detect older adults at risk for malnutrition.
T123 11956-12054 Sentence denotes The questionnaire is composed of 10 items, in a yes (with changing scores)/no (0) response format.
T124 12056-12060 Sentence denotes 3.5.
T125 12061-12071 Sentence denotes Covariates
T126 12072-12272 Sentence denotes We controlled for the socioeconomic variables of gender (dichotomous; 0 = male, 1 = female), age, years of education (both continuous), and marital status (with partner = 1, or without a partner = 0).
T127 12273-12357 Sentence denotes All the instruments were translated into Hebrew and Arabic by bilingual translators.
T128 12358-12408 Sentence denotes The complete questionnaire underwent a pilot test.
T129 12409-12579 Sentence denotes The questionnaire took approximately 15 min to complete, the verbal instructions were comprehensible, and there was no need for further changes prior to administering it.
T130 12581-12585 Sentence denotes 3.6.
T131 12586-12599 Sentence denotes Data Analyses
T132 12600-12639 Sentence denotes The data analyses included four stages.
T133 12640-12834 Sentence denotes In the first stage, descriptive statistics were employed to calculate the means and standard deviations of the continuous variables and the percentage and frequency of the categorical variables.
T134 12835-13003 Sentence denotes In the second stage, in order to test the first hypothesis regarding the difference in subjective age before and during the COVID-19 pandemic, a paired t-test was used.
T135 13004-13272 Sentence denotes In the third stage, bivariate analyses were performed to examine the association between subjective age and the independent variable, mediator variables, and socioeconomic variables using an independent t-test, one-way ANOVA, and Pearson or Spearman correlation tests.
T136 13273-13468 Sentence denotes In the fourth stage, mediation analyses were then computed, and the selected mediators (depressive symptoms and malnutrition) were entered to test the components of the mediation model (Model 4).
T137 13469-13565 Sentence denotes The bootstrapping method was used to assess the indirect effects of the mediation model [62,63].
T138 13566-13945 Sentence denotes Thus, the mediation model was examined by directly testing the significance of the indirect effect of the independent variable (IV; feelings of loneliness) on the dependent variable (DV; subjective age) through the mediators (MeV; depressive symptoms and malnutrition), while controlling for background variables that had been identified in the bivariate analyses as significant.
T139 13946-14176 Sentence denotes This method is based on regression analysis and calculates the direct effect (weight C’, with a mediator), total effect (C, without mediator) and indirect effects (a × b weights) of an independent variable on a dependent variable.
T140 14177-14276 Sentence denotes The total and specific indirect effects were calculated through bootstrapping, set at 5000 samples.
T141 14277-14521 Sentence denotes Confidence intervals were calculated using this method by sorting the lowest to highest of these samples, yielding a 95-percentile confidence interval (if the number 0 falls within the confidence intervals, the tested effect is nonsignificant).
T142 14522-14602 Sentence denotes All analyses were run using SPSS 25.0 with the PROCESS statistical program [62].
T143 14603-14688 Sentence denotes All estimated effects reported by PROCESS are unstandardized regression coefficients.
T144 14690-14692 Sentence denotes 4.
T145 14693-14700 Sentence denotes Results
T146 14701-14847 Sentence denotes Table 1 presents the background variables, the descriptive statistics for the mediators and the independent and dependent variables of the sample.
T147 14848-14993 Sentence denotes The majority of the participants were women, aged between 65 and 95 (mean = 74.3, SD = 6.3) with moderate health status (Mean = 3.61, SD = 1.15).
T148 14994-15091 Sentence denotes Their education ranged from 6 to 21 years (Mean = 10.0, SD = 4.0) and most had a partner (71.1%).
T149 15092-15134 Sentence denotes About 50% were Arabs and the others, Jews.
T150 15135-15208 Sentence denotes No differences were found between the two ethnic groups (data not shown).
T151 15209-15490 Sentence denotes The feelings of loneliness of the participants were medium (Mean = 2.2, SD = 1.1); depressive symptoms were fairly low (Mean = 4.8, SD = 3.2); malnutrition was low-to-medium (Mean = 6.8, SD = 4.3) and subjective age during the COVID-19 pandemic was medium (Mean = 2.94, SD = 1.73).
T152 15491-15561 Sentence denotes The first hypothesis is supported by the results of the paired t-test.
T153 15562-15678 Sentence denotes A difference was indicated between the two times, and the participants felt older during the pandemic (see Table 2).
T154 15679-16021 Sentence denotes The results of the bivariate tests of the association between the research variables and subjective age during the COVID-19 pandemic reveal that the only demographic variable that correlated significantly with subjective age during the crisis was marital status (having a partner correlated positively with lower subjective age, see Table 3).
T155 16022-16143 Sentence denotes The results reveal that all the independent and mediation variables were significantly related to the dependent variable.
T156 16144-16271 Sentence denotes High levels of loneliness, depressive symptoms, and malnutrition correlated positively with subjective age during the pandemic.
T157 16273-16295 Sentence denotes The Mediation Analyses
T158 16296-16616 Sentence denotes Using the PROCESS model 4 [62,63], we tested the second and third hypotheses that during the crisis, feelings of loneliness would be associated directly with subjective age, and indirectly associated with subjective age through depressive symptoms and malnutrition, controlling for covariates (see Table 4 and Figure 1).
T159 16617-16802 Sentence denotes The results indicate a significant total direct effect (path c; without mediators) of loneliness on subjective age, and a significant indirect effect through malnutrition as a mediator.
T160 16803-16905 Sentence denotes No indirect connection was found between the second mediator (depressive symptoms) and subjective age.
T161 16906-16997 Sentence denotes No significant associations were found between the background variables and subjective age.
T162 16999-17001 Sentence denotes 5.
T163 17002-17012 Sentence denotes Discussion
T164 17013-17077 Sentence denotes The present research was conducted during the COVID-19 pandemic.
T165 17078-17299 Sentence denotes During this crisis, older adults are being considered a population at risk; therefore, people of this age are expected to maintain physical distance and reduce the frequency of leaving their home as much as possible [64].
T166 17300-17643 Sentence denotes In light of the loneliness potentially caused by social and physical distancing, the purpose of this study was to examine the possible connection between loneliness and subjective age during the COVID-19 pandemic, and to investigate whether loneliness was indirectly associated with subjective age through depressive symptoms and malnutrition.
T167 17644-17835 Sentence denotes Finally, an attempt was made to determine whether older adults, at a time when their age puts them at risk in terms of physical and mental health, felt older than their chronological age [1].
T168 17836-17991 Sentence denotes The research findings confirm the first hypothesis: the older adults’ subjective age was higher at this time of crisis compared with a less stressful time.
T169 17992-18152 Sentence denotes This result is consistent with those of other studies [1,65] that showed that older adults had a higher subjective age in times of crisis, distress, and stress.
T170 18153-18209 Sentence denotes There are several possible explanations of this finding.
T171 18210-18265 Sentence denotes First, the influence of stress and age are interactive.
T172 18266-18440 Sentence denotes Psychological stress can both imitate and worsen the effects of aging, with older adults usually showing greater immunological impairment and stress than younger adults [65].
T173 18441-18541 Sentence denotes Previous studies have shown that older subjective age is related to higher levels of stress [66,67].
T174 18542-18741 Sentence denotes This could be particularly true for daily stressors, which, if they accumulate, create persistent irritation and overload that may result in more serious stress reactions [68,69] such as less energy.
T175 18742-18829 Sentence denotes The resulting feeling (or actual state) of exhaustion is consistent with feeling older.
T176 18830-19050 Sentence denotes With regard to the second and third hypotheses, the results indicate a direct and positive connection between feelings of loneliness and subjective age; the lonelier the participants, the higher was their subjective age.
T177 19051-19111 Sentence denotes This finding is also consistent with the literature [19,29].
T178 19112-19278 Sentence denotes The size of one’s social network, the satisfaction related to it, and feeling part of the social network have been found to be associated with subjective age [29,70].
T179 19279-19382 Sentence denotes Researchers have also found that the connection between loneliness and subjective age is bidirectional.
T180 19383-19743 Sentence denotes Having a large social network is associated with younger subjective age; older adults who feel younger tend to be friendlier than their cohorts who feel older, and conversely, feeling older than one’s chronological age may limit the desire and capacity for maintaining social relationships, which may reflect compromised physical and emotional well-being [29].
T181 19744-19922 Sentence denotes The examination of two variables that might mediate the direct connection between loneliness and subjective age confirmed the effect of malnutrition, but not depressive symptoms.
T182 19923-20144 Sentence denotes Previous research has addressed the connection between loneliness and malnutrition, and has found that loneliness may affect appetite and nutrient intake through a decline in mood, physical functioning, or cognition [71].
T183 20145-20345 Sentence denotes These, in turn, combined with the difficulty of eating alone and changes in social status, particularly due to the loss of a spouse or friends of the same age group, can further inhibit appetite [72].
T184 20346-20410 Sentence denotes In comparison, eating with others can help prevent malnutrition.
T185 20411-20627 Sentence denotes It increases caloric intake, is related to healthier food habits [73,74], and maintains the motivation of older adults to eat and cook, providing them with opportunities for social interaction and connectedness [75].
T186 20628-20773 Sentence denotes Another possible explanation is the association between deconditioning and loneliness, deconditioning contributes to frailty and fear of falling.
T187 20774-20900 Sentence denotes The fear of falling could also contribute to avoiding grocery shopping and a diminished desire to stand while preparing meals.
T188 20901-21007 Sentence denotes To the best of our knowledge, the finding of a correlation between malnutrition and subjective age is new.
T189 21008-21182 Sentence denotes It can be explained by the findings of previous research that in older adults, a young subjective age is associated with good health, functional health, and wellbeing [4,45].
T190 21183-21434 Sentence denotes Moreover, a comparison between unobserved (blood pressure and telomere length) and observed (grip strength, expiratory flow, and waist circumference) health measures found that the observed health measures were connected to younger subjective age [2].
T191 21435-21605 Sentence denotes Against this background, it can be assumed that inadequate nutrition that leads to malnutrition could become an observed health problem that influences functional health.
T192 21606-21689 Sentence denotes These findings help explain the connection between malnutrition and subjective age.
T193 21691-21693 Sentence denotes 6.
T194 21694-21722 Sentence denotes Conclusions and Implications
T195 21723-21861 Sentence denotes The results of the present study indicate that there is an association between feelings of loneliness and malnutrition and subjective age.
T196 21862-22041 Sentence denotes The primary conclusion is that loneliness affects both malnutrition and subjective age (which, as noted, is associated with numerous negative psychological and physical outcomes).
T197 22042-22385 Sentence denotes To help older adults overcome these feelings, particularly during a pandemic and quarantine, it is important to develop new communication methods such as technologies for managing and addressing the needs of the older population, technologies for managing and providing remote medical services, and technologies to encourage social engagement.
T198 22386-22543 Sentence denotes Older adults who do not have access to advanced social network technologies can use more basic technologies like routine phone calls with family and friends.
T199 22544-22707 Sentence denotes MAH (Mental Health America) suggests 10 structured question in order to make a brief check on the physical, social, mental and nutritional status of older adults).
T200 22708-22865 Sentence denotes Moreover, volunteers and friends can visit under the Covid-19 safety regulations, or occasional visits to a park and being among other people can be helpful.
T201 22866-22991 Sentence denotes Similarly, the families of older adults should receive guidance on technology, so that they can meet while social distancing.
T202 22992-23109 Sentence denotes Another option is to encourage neighbors in the same building to talk to each other and find ways for mutual support.
T203 23110-23293 Sentence denotes Apart from loneliness, it is necessary to address the issue of subjective age, which has been found to rise during crises in general, and during the current quarantine, in particular.
T204 23294-23349 Sentence denotes Subjective age is associated with many health outcomes.
T205 23350-23543 Sentence denotes Therefore, when older adults are required to stay home as much as possible, it is imperative that policymakers take measures to relieve their loneliness and see that they have proper nutrition.
T206 23544-23807 Sentence denotes One possible means for achieving these two related outcomes is to provide psychological-nutrition intervention [76] by telephone (this kind of intervention includes a weekly telephone call for about half an hour, including general talks and nutrition guidelines).
T207 23808-23924 Sentence denotes This would provide human contact, as well as nutritional guidelines and encouragement to cook and eat healthy foods.
T208 23925-23980 Sentence denotes Three limitations of the current study should be noted.
T209 23981-24109 Sentence denotes One is the cross-sectional study design, which does not allow for the prediction of a causal relationship between the variables.
T210 24110-24248 Sentence denotes Future research should use longitudinal data to examine the relationship between feelings of loneliness, malnutrition, and subjective age.
T211 24249-24324 Sentence denotes A further limitation is the use of only one question concerning loneliness.
T212 24325-24406 Sentence denotes However, previous studies have also used a single question for this purpose [77].
T213 24407-24584 Sentence denotes Third, the ability to generalize the findings is limited, because the sample and the sampling procedure did not guarantee the representativeness of Jewish and Arab older adults.
T214 24585-24687 Sentence denotes The sample included only older adults who answered the telephone at the moment the researchers called.
T215 24688-24775 Sentence denotes Those who did not answer or did not have a telephone are not represented in this study.
T216 24776-24913 Sentence denotes Fourth, all variables were measured at the same time, therefore, general attitudes and emotions may have had an influence on all ratings.
T217 24914-24964 Sentence denotes These various factors may have biased the results.
T218 24965-25216 Sentence denotes Despite these limitations and the difficulty of making generalizations, the present study provides initial insights into the mechanisms of the association between loneliness, malnutrition, and subjective age during periods of imposed social isolation.
T219 25217-25389 Sentence denotes Future research could use a randomized sample that includes a personal income variable for each participant since personal income has a direct effect on nutritional intake.
T220 25390-25826 Sentence denotes Another possible topic of study could address malnutrition and feelings of loneliness due to reduced hearing/vision abilities in older adults, and the difficulty of shopping and cooking on the one hand and keeping social relationships on the other hand, especially in times of crisis such as the COVID-19 pandemic when communication is very difficult due to the masks, especially for older adults with reduced vision/ hearing abilities.