Increased Social Interactions Reduce the Association Between Constricted Life-Space and Lower Daily Happiness in Older Adults With and Without HIV: A GPS and Ecological Momentary Assessment Study

• Published in: The American journal of geriatric psychiatry 2021-08, Vol.29 (8), p.867-879
• Main Authors: Kamalyan, Lily, Yang, Jiue-An, Pope, Caitlin N., Paolillo, Emily W., Campbell, Laura M., Tang, Bin, Marquine, María J., Depp, Colin A., Moore, Raeanne C.
• Format: Article
• Language: English
• Subjects: Activities of daily living; Aged; Aged, 80 and over; aging; Ecological Momentary Assessment; Geographic Information Systems; Happiness; HIV; HIV Infections; Human immunodeficiency virus; Humans; isolation; mobile health; mood; Older people; Remote assessment; Smartphones; Social Interaction; Social networks; well-being
• ISSN: 1064-7481; 1545-7214; 1545-7214
• DOI: 10.1016/j.jagp.2020.11.005

•What is the primary question addressed by this study? Our study elucidated the relationship between constricted life-space, mood, fatigue, and pain, and social engagement among older adults living with and without HIV.•What is the main finding of this study? Older adults living with HIV are more likely to spend more time at home, have lower ratings of daily happiness, and have fewer social interactions per day than HIV-. For older adults, regardless of HIV status, while spending less time at home is associated with higher ratings of happiness, participating in social interactions reduces this relationship (i.e. having more social interactions is associated with being happier, same day and next day).•What is the meaning of the finding? In this time of COVID-19 precautions, staying in contact with others and maintaining social interactions may provide daily emotional support, particularly important for people living with HIV. 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. 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. 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. Accounting for engagement in