THE RELATIONSHIP BETWEEN SOCIAL EXCLUSION, LOW HEDONISTIC EATING HABITS, AND DELIRIUM İN ELDERLY INDIVIDUALS
DOI:
https://doi.org/10.18623/rvd.v23.n4.4599Keywords:
Older, Older Adult, Social Exclusion, Low Hedonistic Eating Habits, DeliriumAbstract
Delirium in older adults can be shaped by their experiences of social isolation and a reduction in pleasure-oriented eating habits. When elderly individuals become disconnected from their social environment, this separation can trigger both psychological and biological changes that influence their overall well-being. The aging process entails multidimensional changes in individuals’ biological, psychological, and social functioning. The aim of this study is to examine the relationships between levels of delirium and social exclusion and hedonic eating behaviors among individuals aged 65 years and older. In line with its cross-sectional design, the study avoids causal inferences and addresses the relationships between variables within a descriptive and correlational framework. This study aims to explore how strongly social isolation and reduced pleasure-driven eating behaviors relate to the development of delirium in elderly individuals living in institutional care settings. This descriptive research was carried out in In 2025 Erzincan and involved older individuals living in the 100th Year Atatürk Nursing Home, the Refahiye Elderly Care Center, and the Kemah Nursing Home. Information was gathered through an elderly demographic form along with the Social Exclusion Scale, the Low Hedonistic Eating Habits Scale, and the Delirium Scale. The dataset was analyzed using descriptive statistics as well as independent samples t-tests, ANOVA, correlation analyses, and regression procedures. In this study, a convenience sampling method was employed.
References
Adams, K. B. (2004). Loneliness and depression in independent living retirement communities: Risk and resilience factors. Aging & Mental Health, 8(6), 475–485.
Ahmed, T., & Haboubi, N. (2010). Assessment and management of nutrition in older people and its importance to health. Clinical Interventions in Aging, 5(1), 207–216.
Alataş, H., Arslan, N., & Aytaş, O. (2023). The relationship of depression and malnutrition with healthy eating index in elderly individuals. Medicine Science, 12(3), 922–928.
Alataş, H., Serin, Y., & Arslan, N. (2023). Nutritional status and risk of sarcopenia among hospitalized older adults residing in a rural region in Turkey. Annals of Geriatric Medicine and Research, 27(4), 293–300.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
Apak, E., & Apak, H. (2020). Yaşlılarda sosyal dışlanma ölçeğinin geliştirilmesi: Geçerlik ve güvenirlik çalışması. Kadim Akademi Sosyal Bilimler Dergisi, 4(1), 1–15.
Atik, D., Neşe, A., & Özcan Yüce, U. (2019). Scale development study: Hedonistic Eating Scale. Acta Medica Alanya, 3(2), 147–153.
Aytaş, O., & Alataş, H. (2023). The relationship between food addiction and emotional eating in individuals at risk for anorexia nervosa. European Journal of Medicine and Pharmacology, 27(17), 8081–8089.
Bellelli, G., Brathwaite, J. S., & Mazzola, P. (2021). Delirium: A marker of vulnerability in older people. Frontiers in Aging Neuroscience, 13, 1–13.
Boulos, C., Salameh, P., & Barberger-Gateau, P. (2017). Social isolation and risk for malnutrition among older people. Geriatrics & Gerontology International, 17(2), 286–294.
Bramati, P., & Bruera, E. (2021). Delirium in palliative care. Cancers, 13(23), 1–11.
Cacioppo, J. T., & Cacioppo, S. (2014). Social relationships and health: The toxic effects of perceived social isolation. Social and Personality Psychology Compass, 8(2), 58–72.
Cole, M. G. (2005). Delirium in elderly patients. American Journal of Psychiatry, 3(2), 320–332.
Commins, P. (2004). Poverty and social exclusion in rural areas: Characteristics, processes and research issues. Sociologia Ruralis, 44(5), 60–75.
Cornwell, E. Y., & Waite, L. J. (2009). Measuring social isolation among older adults using multiple indicators from the NSHAP study. The Journals of Gerontology: Series B, 64(1), 38–46.
Çınar, M. A., Özmenler, K. N., Özşahin, A., & Trzepacz, P. T. (2014). Reliability and validity of the Turkish translation of the Delirium Rating Scale–Revised-98. Düşünen Adam, 27(3), 186–194.
Dean, A., Kolody, B., Wood, P., & Matt, G. E. (1992). The influence of living alone on depression in elderly persons. Journal of Aging & Health, 10(6), 583–591.
Deepti, K., Ulf, G., & Julius, P. (2015). Delirium in the elderly: Current problems with increasing geriatric age. Indian Journal of Medical Research, 142(6), 655–662.
Donini, L. M., Scardella, P., Piombo, L., Neri, B., Asprino, R., Proietti, A. R., Carcaterra, S., & Cannella, C. (2013). Malnutrition in elderly: Social and economic determinants. Journal of Nutrition, Health & Aging, 17(1), 9–15.
Finlayson, G., King, N., & Blundell, J. E. (2007). Is it possible to dissociate ‘liking’ and ‘wanting’ for foods in humans? Physiology & Behavior, 90(1), 36–42.
Iglseder, B., Frühwald, T., & Jagsch, C. (2022). Delirium in geriatric patients. Wiener Medizinische Wochenschrift, 172, 114–121.
Illario, M., Vollenbroek-Hutten, M. M., Molloy, D. W., Menditto, E., Iaccarino, G., & Eklund, P. (2016). Active and healthy ageing and independent living. Journal of Aging Research, 1–8.
Inouye, S. K. (2000). Prevention of delirium in hospitalized older patients. Annals of Medicine, 32(4), 257–263.
Inouye, S. K., et al. (2014). Delirium in elderly people. The Lancet, 383(9920), 911–922.
Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: Evaluation and management. American Family Physician, 90(3), 150–158.
Kaneko, M., & Ueda, Y. (2023). Dispositional need to belong and increased eating after social exclusion. Frontiers in Psychology, 23(2), 1–8.
Kumar, P., Waiter, G. D., Dubois, M., Milders, M., Reid, I., & Steele, J. D. (2017). Increased neural response to social rejection in major depression. Depression and Anxiety, 34(11), 1049–1056.
Lee, S. (2021). Social exclusion and subjective well-being among older adults in Europe. The Journals of Gerontology: Series B, 76(2), 425–434.
Levitas, R., Pantazis, C., Fahmy, E., Gordon, D., Lloyd, E., & Patsios, D. (2007). The multi-dimensional analysis of social exclusion. University of Bristol.
Li, S., Zhao, F., & Yu, G. (2021). Social exclusion and depression among college students. Current Psychology, 40, 1144–1151.
Liu, Y., & Jiang, H. (2025). The impact of social isolation on subjective cognitive decline in older adults. arXiv Preprint.
Lowe, M. R., & Butryn, M. L. (2007). Hedonic hunger: A new dimension of appetite? Physiology & Behavior, 91(4), 432–439.
Lowe, M.R., Thomas, J. & Safer, D.L. (2007). Butryn ML. The relationship of weight suppression and dietary restraint to binge eating in bulimia nervosa. Physiology & Behavior, 91, 432–439.
Macht, M. (2008). How emotions affect eating: A five-way model. Appetite, 50(1), 1–11.
Maheshkumar, T., & Rajan, S. I. (2024). Risk factors of social exclusion among older persons. Ageing International, 49, 914–939.
Mittal, V., Muralee, S., Williamson, D., et al. (2011). Delirium in the elderly: A comprehensive review. American Journal of Alzheimer’s Disease & Other Dementias, 26(2), 97–109.
Nicholson, N. R. (2012). Social isolation in older adults. Journal of Primary Prevention, 33(2–3), 137–152.
Niu, G.F., Shi, X.H. & Yao, L.S. et al. (2023). Social Exclusion and Depression among undergraduate students: the mediating roles of rejection sensitivity and social self-efficacy. Current Psychology, 42(3), 24198–24207.
Oaten, M., Williams, K. D., Jones, A., & Zadro, L. (2008). The effects of ostracism on self-regulation in the socially anxious. Journal of Social Clinic. Psychology,. 27(5), 471–504.
Oluyinka, O., et al. (2024). Social support, loneliness and depression. BMC Geriatrics, 24, 854.
O’Malley, G., Leonard, M., Meagher, D., & O’Keeffe, S. T. (2008). The delirium experience. Journal of Psychosomatic Research, 65(3), 223–228.
Oh, E. S., Fong, T. G., Hshieh, T. T., & Inouye, S. K. (2017). Delirium in older persons. JAMA, 318(12), 1161–1174.
Popovic, S. & Masanovic, B. (2019). Effects of Physical and Social Activity on Physical Health and Social Inclusion of Elderly People. Iran Journal Public Health, 48(10), 1922-1923.
Prell, T., Stegmann, S. & Schönenberg, A. (2023). Social exclusion in people with diabetes: cross-sectional and longitudinal results from the German Ageing Survey (DEAS). Scientific Reports, 13, 1-10.
Quinlan, N., Marcantonio, E. R., Inouye, S. K., Gill, T. M., Kamholz, B., & Rudolph, J. L. (2011). Vulnerability: The crossroads of frailty and delirium. Journal of the American Geriatrics Society, 59(2), S262–S268.
Saito, E., Sagawa, Y., & Kanagawa, K. (2005). Social support as a predictor of health status among older adults living alone in Japan. Nursing and Health Sciences, 7(1), 29–36.
Santini, Z. I., Koyanagi, A., Tyrovolas, S., & Haro, J. M. (2015). Social support mediates loneliness and depression. Aging & Mental Health, 19(4), 367–374.
Schrempft S, Jackowska M, Hamer M, Steptoe A. Associations between social isolation, loneliness, and objective physical activity in older men and women. BMC Public Health. 2019;19(1):74.
Schiffman, S.S. (1997). Taste and smell losses in normal aging and disease. JAMA, 278, 1357–1362.
Trzepacz, P.T. (2017). Delirium. In: Tousi, B., Cummings, J. (eds) Neuro-Geriatrics. Springer, Cham.
Yu, R., Cheung, O., Leung, J., Ho, K., & Woo, J. (2021). Social isolation and cognitive decline among older adults. Ageing Research Reviews, 66, 101251.
Yuan, S., et al. (2023). Loneliness and depression among community-dwelling older adults: The role of social support and isolation. Medicine, 102(38), e3456.
Wen, X., Liu, Y., & Zhang, Z. (2024). Social participation and cognitive outcomes in later life: A longitudinal perspective. Aging & Mental Health, 28(1), 45–54.
Whitelock, E. & Ensaff, H. (2018). On Your Own: Older Adults’ Food Choice and Dietary Habits. Nutrients, 10(4), 1-17.
Wilson, K., Mottram, P., & Sixsmith, A. (2007). Depressive symptoms in the very old living alone: prevalence, incidence and risk factors. International Journal of Geriatric Psychiatry, 22(4), 361–366.
Witt, A.A. & Lowe, M.R. (2014), Low hedonic hunger and binge eating among women with eating disorders. International Journal Eating Disorders, 47(3), 273-280.
World Health Organization. (2015). World report on ageing and health. WHO.
Downloads
Published
How to Cite
Issue
Section
License
I (we) submit this article which is original and unpublished, of my (our) own authorship, to the evaluation of the Veredas do Direito Journal, and agree that the related copyrights will become exclusive property of the Journal, being prohibited any partial or total copy in any other part or other printed or online communication vehicle dissociated from the Veredas do Direito Journal, without the necessary and prior authorization that should be requested in writing to Editor in Chief. I (we) also declare that there is no conflict of interest between the articles theme, the author (s) and enterprises, institutions or individuals.
I (we) recognize that the Veredas do Direito Journal is licensed under a CREATIVE COMMONS LICENSE.
Licença Creative Commons Attribution 3.0
