Determinants of Well-Being Among Elderly Residents of Selected Old Age Homes in Kolkata: A Cross-Sectional Study.

The Trier Social Stress Test (TSST) [] is a well-established laboratory paradigm aimed to elicit reliable acute psychobiological stress responses []. Over the decades, researchers have developed various modified versions that are adapted to participants' characteristics (e.g., young age [,]) or the modern digital world (e.g., virtual-reality [], or online-based TSST [])). The laboratory setting, usually located at a research institute, is associated with challenges, such as travel burden for participants, and environmental and spatial requirements for researchers. For potential participants who are unable to travel to a research institution (due to age, mobility, or geographical restrictions), a home version of the TSST may be a solution. There are online versions of the TSST [, , ] which allow individuals to participate from home, however, they require certain technical conditions (e.g., computer device including camera, stable internet connection), and lack ‘real’ in-person interactions, reportedly resulting in lower cortisol responses than the original laboratory-based TSST []. We have developed the TSST-home, which overcomes these limitations and shares the essential characteristics with the laboratory version. The aim of the current within-subject, crossover, single-blind study was to investigate the feasibility and ability of the TSST-home to elicit stress responses across multiple systems (i.e. biological and psychological). We hypothesize that compared to the placebo-TSST-home, the TSST-home will elicit significant acute stress responses across the most-commonly assessed stress markers (i.e., perceived stress, salivary cortisol, salivary alpha-amylase, heart rate). Prospective participants were recruited via flyers (e.g., notice boards of local universities) and social media (Facebook) and screened using a telephone-based interview. For this pilot study, we studied a relatively homogenous sample of healthy, young men to control for possible confounding effects on the stress measures. The inclusion criteria were the following: a) male biological sex/gender b) young adults (18-35 years), c) BMI 18-25 kg/cm, d) fluency in German, and e) living in Vienna, with at least two separate rooms for conducting the study. We excluded participants who reported a) regular smoking (≥5 cigarettes/week), b) drug/medication use, c) mental/somatic disorders, d) (night) shift work, and e) previous experience with the TSST. Participants were compensated 80 € for their study participation. A summary of the characteristics of the participants’ home settings and their preference for study location (university vs. home) is provided in . Using G*Power [] for the priori sample size estimation (expected medium effect size of 0.25, power of 0.90, p value of 0.05, two conditions, eight time points), at least 24 participants were required. Data collection occurred between February 2020 and June 2023. Given that this timeframe overlapped with the Covid-19 pandemic (Covid-19 measures were implemented accordingly, see ) and associated repeated lockdowns and governmental restrictions, our final study sample was smaller than originally planned. For this pilot study, we report results for 17 male participants (mean age ± standard deviation, range: 23.59 ± 2.92, 18-30 years; BMI: 22.35 ± 1.41, 19.10-24.78 kg/m).