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In the last decades, the relationship between social networking sites (SNSs) and older people's loneliness is gaining specific relevance. Studies in this field are often based on qualitative methods to study in-depth self-perceived issues, including loneliness and well-being, or quantitative surveys to report the links between information and communication technologies (ICTs) and older people's well-being or loneliness. However, these nonexperimental methods are unable to deeply analyze the causal relationship. Moreover, the research on older people's SNS use is still scant, especially regarding its impact on health and well-being. In recent years, the existing review studies have separately focused their attention on loneliness and social isolation of older people or on the use of ICTs and SNSs in elderly populations without addressing the relationship between the former and the latter. This thorough qualitative review provides an analysis of research performed using an experimental or quasi-experimental design that investigates the causal effect of ICT and SNS use on elderly people's well-being related to loneliness. The aims of this review are to contrast and compare research designs (sampling and recruitment, evaluation tools, interventions) and the findings of these studies and highlight their limitations. Using an approach that integrates the methodological framework for scoping studies and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews, we identified 11 articles that met our inclusion criteria. A thematic and content analysis was performed based on the ex post categorization of the data on the selected studies, and the data were summarized in tables. The analysis of the selected articles showed that: (1) ICT use is positively but weakly related to the different measures of older people's well-being and loneliness, (2) overall, the studies under review lack a sound experimental design, (3) the main limitations of these studies lie in the lack of rigor in the sampling method and in the recruitment strategy. The analysis of the reviewed studies confirms the existence of a beneficial effect of ICT use on the well-being of older people in terms of reduced loneliness. However, the causal relationship is often found to be weak. This review highlights the need to study these issues further with adequate methodological rigor.

Major global problems such as population ageing, long-term care and the socio-economic burden of chronically ill older people and their families are urgent issues. Research in this field contributes to the growing international literature on health-related quality-of-life instruments, but little is known about the links between the related variables. Thus, the scoping review this protocol refers to plans to examine the socio-economic consequences of older people’s poor health on their economic conditions and their families. In particular, the main aims are: a) to map the main concepts that characterize the body of the reference literature; b) to identify conceptual gaps or unexplored research areas to be addressed; c) to illuminate the difficulties that affect a large number of families with older members to care for, with particular attention to the concept of socio-economic deprivation, which includes material living conditions as well as social aspects (e.g. in the form of loneliness experienced as a consequence of health disorders). This protocol paper fulfils the purpose of clarifying the planned methodological phases, including the sub-phases, and listing the techniques used. A three-step approach is being applied, consisting of: pre-planning phase, protocol phase, and conduction and reporting phase. The preliminary stages of the protocol design are part of a dedicated project within the Open Science Framework platform and included in a Research Square preprint. This proposed project will contribute to multidisciplinary research on the connections between ill health and poverty, and could support critical reflections on the current evidence and guide future policies to alleviate this double burden.

Purpose Population ageing and rising poverty are two of the most pressing issues today, even in Western European nations, growing as a result of the recent global economic crisis and the COVID-19 containment measures. This study explores the relationship between long-term care (LTC) needs and risk of poverty at household level in eight European countries, representing the different European care regimes. Methods The main international databases were scoured for study variables, categorized according to the following conceptual areas: home care, residential care, health expenditure, service coverage, cash benefits, private services, population, family, education, employment, poverty, disability and care recipients, and life expectancy. We initially identified 104 variables regarding 8 different countries (Austria, Finland, Germany, the Netherlands, Italy, Spain, Poland, Romania). Statistical analyses were conducted as described hereafter: analysis of the Pearson’s Bivariate Correlation between the dependent variable and all other variables; a Multivariable Linear Regression Model between the Poverty Index (dependent variable) and the covariates identified in the preceding step; a check for geographical clustering effects and a reduced Multivariable Linear Regression Model for each identified European cluster. Results The variables that addressed the risk of poverty pertained to the area of policy intervention and service provision. Rising private out-of-pocket health expenditures and proportion of “poor” couples with at least one child are two factors that contributed significantly to poverty increasing. Moreover, rising private out-of-pocket health expenditures for covering LTC needs (even in presence of public financial contribution to the family) is the main contributor to household poverty increasing in presence of ADL disability. Conclusion The results reveal the existence of a clear correlation between the need for LTC and the risk of poverty in households across Europe. These results highlight the central relevance of LTC policies, which are often still treated as marginal and sectoral, for the future sustainability of integrated care strategies.

Background Loneliness and social isolation can occur at any stage of life, but some predictors may be more common among older adults. Due to growing population ageing, loneliness and social isolation are relevant social issues. Many studies apply the main definitions of loneliness and social isolation offered by the literature without considering how individual representations, socio-cultural context and the culture of care may influence their perception. This study wishes to fill in these literature gaps by analysing empirical definitions of loneliness and social isolation arising from a mixed-gender randomized sample of Italian oldest old people. Methods Between January and March 2019, 132 older people, most aged 80+, living in a northern Italian town, were asked to answer a questionnaire and a semi-structured interview. According to a mixed-method analysis the definitions of loneliness and social isolation were analysed by respondents’ gender, living arrangement (e.g., living alone or with partners or other people), and years of education to find possible associations to the meanings attributed to the two concepts. Results The sample was gender-balanced and mid-low educated; more than one fourth of respondents lived alone. The results underline how the empirical definitions of loneliness and social isolation are closer to each other than the academic ones. The two concepts are often perceived by participants as distinct, but they are strongly interconnected so that they can be used interchangeably by older Italian people. The two main themes identified by the analysis are loneliness as “death” and social isolation as “guilt”. In the respondents’ opinion, the main loneliness driver is the loss of loved, close persons, while social isolation is driven by disability. Age, educational level, and living arrangements did not influence the meanings attributed to social isolation. On the contrary, living arrangement ( P  = 0.002) and educational level ( p  = 0.023) seem to influence the empirical definitions of loneliness. Conclusion The knowledge of the meanings that oldest old give to the two concepts may inspire advanced intervention aimed at buffering the psychological and social consequences of loneliness and social isolation in the older population.

Background Influenza can cause serious complications in individuals with chronic diseases. Although vaccination is strongly recommended for the high-risk population, uptake remains suboptimal. This retrospective cohort study assessed the relationship between demographic, clinical, and socio-economic (SE) factors and influenza vaccination uptake among high-risk patients in the Apulia region over four influenza seasons (2019–2023). Methods Data on comorbidities, vaccination history, and demographics were extracted from the User Fee Exemption Registry, the Immunization Information System, and the Total Population Register, respectively. Each geocoded case was linked to the Italian National Deprivation Index to determine SE status at the census tract level. Descriptive statistics, logistic regression, and multilevel mixed general linear models were used to analyze factors associated with vaccination uptake. Results Vaccination coverage among people with longstanding illnesses was 35.5% in 2019–2020, peaked at 44.7% in 2020–2021, and declined thereafter (42.9% in 2021 − 2022; 40.1% in 2022 − 2023). Higher uptake was associated with female sex, older age, and a greater number of comorbidities. SE deprivation was inversely associated with vaccination uptake. Individuals with chronic renal/adrenal insufficiency, cardiovascular, or neoplastic diseases had the highest uptake. The data also suggest a potential link between marital status and the likelihood of vaccination. Conclusions Demographic, SE, and clinical factors may play a significant role in influenza vaccination uptake. Public health strategies should consider these determinants to improve coverage and reduce health inequalities.

Background COVID-19 has been characterised by its global and rapid spread, with high infection, hospitalisation, and mortality rates worldwide. However, the course of the pandemic showed differences in chronology and intensity in different geographical areas and countries, probably due to a multitude of factors. Among these, socio-economic deprivation has been supposed to play a substantial role, although available evidence is not fully in agreement. Our study aimed to assess incidence and fatality rates of COVID-19 across the levels of socio-economic deprivation during the first epidemic wave (March–May 2020) in the Italian Province of Foggia, Apulia Region. Methods Based on the data of the regional active surveillance platform, we performed a retrospective epidemiological study among all COVID-19 confirmed cases that occurred in the Apulian District of Foggia, Italy, from March 1st to May 5th, 2020. Geocoded addresses were linked to the individual Census Tract (CT) of residence. Effects of socio-economic condition were calculated by means of the Socio-Economic and Health-related Deprivation Index (SEHDI) on COVID-19 incidence and fatality. Results Of the 1054 confirmed COVID-19 cases, 537 (50.9%) were men, 682 (64.7%) were 0–64 years old, and 338 (32.1%) had pre-existing comorbidities. COVID-19 incidence was higher in the less deprived areas (p < 0.05), independently on age. The level of socio-economic deprivation did not show a significant impact on the vital status, while a higher fatality was observed in male cases (p < 0.001), cases > 65 years (p < 0.001), cases having a connection with a nursing home (p < 0.05) or having at least 1 comorbidity (p < 0.001). On the other hand, a significant protection for healthcare workers was apparent (p < 0.001). Conclusions Our findings show that deprivation alone does not affect COVID-19 incidence and fatality burden, suggesting that the burden of disease is driven by a complexity of factors not yet fully understood. Better knowledge is needed to identify subgroups at higher risk and implement effective preventive strategies.

Background In Italy, migrant family care assistants (MFCAs) represent the most cost-effective answer to dementia home care need and to desire of ageing in place of older adults and family caregivers. Nevertheless, MFCAs very often have no training in elder care and even less in the dementia care. Conversely, elder care training may improve MFCAs’ working condition and mental health. Exploring MFCAs’ educational needs is one of the objectives of the “Age-It” project, aiming at advancing knowledge and competences on ageing by applying a holistic, interdisciplinary, and problem-solving approach through the synergic work of research and educational institutions, care providers and civil society associations, businesses and industries. Methods In Autumn 2023, 25 semi-structured questionnaires, including both closed and open-ended questions, were conducted with MFCAs living in two Italian regions: Marche and Molise. The research material was thematically analysed to answer four research questions: Which is the work experience of MFCAs of older adults with long-term care needs? Which are their educational needs? Which are the barriers to training? Did the emigration geographical area of respondents and the migration route influence their willingness to attend an elder care training? Results Three main themes were identified: (1) Migration: a painful choice to flee poor (violent) societies; (2) Elder care: a stressful work; (3) Needs and barriers to elder care education. Most interviewed MFCAs face many difficulties at work, including stress, burden and lack of free time. Many respondents expressed the need and willingness to improve their knowledge on ageing processes, dementia, behavioural disorders, medicine administration, bedsores and injuries medication. The 24 h work represents the main barriers to attend the lessons. Discussion Suggestions for future trainings include a co-designed curriculum embedding contents on dementia and behavioural disorders; self-care and resilience; host country language. Concerning policy and practice recommendations, mandatory, free and periodic, blended trainings, a clear offer of elder care education, the recognition of previous courses at EU and national level are encouraged. Conclusions Given the pivotal role of MFCAs in the LTC in Italy, it is urgent that they are adequately trained. Given the stressful and 24 h work, a co-designed e-learning platform may be a promising means for reaching and training them. Clinical trial number Not applicable

Older adults make little use of social networking sites (SNS). SNS has become essential for maintaining social contacts and countering loneliness in the current era marked by the Covid-19 pandemic. This study explores the attitudes of the oldest-old on SNS after attending a training course on SNS use. The study’s goals are to investigate their personal experiences, choices of use and to survey their views on the usefulness of SNS and its effects on mitigating loneliness for older people. The interviews were conducted in the context of the “Ageing in a Networked Society—Social Experiment Study.” The participants, who were randomly selected for the course on SNS use, agreed to be interviewed during the post-intervention evaluation (N = 39). Results show SNS are mainly and productively used with relatives and friends. A positive view is reported for the potential impact of using SNS to counter loneliness, but mainly for socially isolated older individuals, while only a few find online contact futile. Intergenerational communication and a perspective of SNS as a leisure activity were identified as motivational factors for SNS use. Rare use or non-use are mainly related to privacy and security issues and technical difficulties. This is also the reason underlying the majority’s preference for WhatsApp over Facebook. These findings confirm the need for widespread SNS-focused online communication training interventions for seniors. On the speculative level, these results complement the existing literature by delving deeper into the perceptions of new older SNS users, a poorly studied segment of the population.

The sustainability of European Long-Term Care systems faces the demographic and socio-economic circumstances, mainly the increasing ageing of the population, with its chronic disease conditions, and the simultaneous economic general crises, exacerbated by the recent COVID-19 pandemic. Beyond the increase in general rate of relative poverty, there is a higher risk of poverty among elderly and families in a high demand of care, especially if situations of Activities Daily Living (ADL) disability are present. Italian welfare, which is based on family care regimes and regional strategies, and is oriented to private or public care, is a relevant case study with which to analyze such a relationship. This paper aims to study the relationship between ADL disability and the socio-economic deprivation of families, that is, household poverty. Variables came from the ISTAT Health for All Italian Database and the INAIL Disability Allowance Database. A pool of statistical methods, based on bivariate and multivariate analyses, from bivariate correlation, through multiple linear regression to principal component factor analysis, were used to reduce the number of the variables and compute the indicators. The multivariate analysis underlines how ADL disability impacts on a household’s poverty, confirming the existence of statistical correlation between them. Moreover, the study identifies and measures two answer capability models to cope with household poverty. The answer capability of the formal system is the main tool for reducing poverty due to one family member’s ADL disability. Integration and collaboration between the formal system and family capabilities remains the main solution.

The debate on policies addressing the challenges posed by population ageing pays increasing attention to sustainable and innovative ways to tackle the multidimensional impact this phenomenon has on society and individuals. Moving from the findings of two European research projects, a qualitative study based on a rapid review of the literature, expert interviews, focus groups and case studies analysis has been carried out in Italy. This study illustrates which social innovations have been recently implemented in this country’s long-term care (LTC) sector, and the areas in which further steps are urgently needed in the future. This takes place by first highlighting the existing links between social innovation and LTC, and then by identifying the key factors that can facilitate or hinder the implementation of these initiatives. Finally, the study suggests how to promote social innovation, by strengthening the “integration” and “coordination” of available services and resources, through a—for this country still relatively—new approach towards ageing, based on pillars such as prevention and education campaigns on how to promote well-being in older age.