Objective: Older persons with human immunodeficiency virus (HIV) (PWH) are particularly susceptible to life-space restrictions. The aims of this study included: 1) using global positioning system (GPS) derived indicators as an assessment of time spent at home among older adults with and without HIV; 2) using ecological momentary assessment (EMA) to examine real-time relationships between life-space, mood (happiness, sadness, anxious), fatigue, and pain; and 3) determining if number of daily social interactions moderated the effect of life-space on mood. Methods: Eighty-eight older adults (PWH n = 54, HIV-negative n = 34) completed smartphone-based EMA surveys assessing mood, fatigue, pain, and social interactions four times per day for two weeks. Participants’ smartphones were GPS enabled throughout the study. Mixed-effects regression models analyzed concurrent and lagged associations among life-space and behavioral indicators of health. Results: PWH spent more of their time at home (79% versus 70%, z = −2.08; p = 0.04) and reported lower mean happiness (3.2 versus 3.7; z = 2.63; p = 0.007) compared to HIV-negative participants. Controlling for covariates, more daily social interactions were associated with higher ratings of real-time happiness (b = 0.12; t = 5.61; df = 1087.9; p< 0.001). Similar findings were seen in lagged analyses: prior day social interactions (b = 0.15; t = 7.3; df = 1024.9; p < 0.0001) and HIV status (b = −0.48; t = −2.56; df = 1026.8; p = 0.01) attenuated the effect of prior day time spent at home on happiness. Conclusion: Accounting for engagement in social interactions reduced the significant effect of time spent at home and lower happiness. Interventions targeting social isolation within the context of constricted life-space may be beneficial for increasing positive mood in older adults, and especially relevant to older PWH.
|Number of pages||13|
|Journal||American Journal of Geriatric Psychiatry|
|State||Published - Aug 2021|
Bibliographical noteFunding Information:
This work was supported by the National Institutes of Health : NIMH K23 MH107260 and NIMH K23MH107260 S1 to R.C.M., NIMH P30MH62512 (The HIV Neurobehavioral Research Center [HNRC] ), NIA R01AG062387 to R.C.M., NIMH R01116902 to C.A.D, NIMH R21MH116104 to R.C.M., NIDA T32DA031098 to L.M.C., NIAAA F31AA027198 to E.W.P., NIAAA T32AA013525 to L.K. and R25MH108389 to C.N.P. R.C.M. is a co-founder of KeyWise, Inc. and a consultant for NeuroUX. The terms of these arrangements have been reviewed and approved by the UCSD in accordance with its conflict of interest policies. For the remaining authors no conflicts of interest were declared.
© 2020 American Association for Geriatric Psychiatry
- Remote assessment
- mobile health
ASJC Scopus subject areas
- Geriatrics and Gerontology
- Psychiatry and Mental health