Effectiveness of Technology Interventions in Addressing Social Isolation, Connectedness, and Loneliness in Older Adults: Systematic Umbrella Review

Abstract

Background The global population of older adults (aged >60 years) is expected to triple to 2 billion by 2050. Proportionate rises in older adults affected by loneliness and social isolation (or social connectedness) are expected. Rapid deployability and social changes have increased the availability of technological devices, creating new opportunities for older adults. Objective This study aimed to identify, synthesize, and critically appraise the effectiveness of technology interventions improving social connectedness in older adults by assessing the quality of reviews, common observations, and derivable themes. Methods Following the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), 4 databases (PsycINFO, PubMed, Embase, and MEDLINE) were searched between February 2020 and March 2022. We identified reviews with adults aged ≥50 years in community and residential settings, reporting outcomes related to the impact of technologies on social disconnectedness with inclusion criteria based on the population, intervention, context, outcomes, and study schema—review-type articles (systematic, meta-analyses, integrative, and scoping)—and with digital interventions included. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to measure the strength of outcome recommendations including the risk of bias. The reviews covered 326 primary studies with 79,538 participants. Findings were extracted, synthesized, and organized according to emerging themes. Results Overall, 972 publications met the initial search criteria, and 24 met our inclusion criteria. Revised Assessment of Multiple Systematic Reviews was used to assess the quality of the analysis. Eligible reviews (3/24, 12%) were excluded because of their low Revised Assessment of Multiple Systematic Reviews scores (<22). The included reviews were dedicated to information and communications technology (ICT; 11/24, 46%), videoconferencing (4/24, 17%), computer or internet training (3/24, 12%), telecare (2/24, 8%), social networking sites (2/24, 8%), and robotics (2/27, 8%). Although technology was found to improve social connectedness, its effectiveness depended on study design and is improved by shorter durations, longer training times, and the facilitation of existing relationships. ICT and videoconferencing showed the best results, followed by computer training. Social networking sites achieved mixed results. Robotics and augmented reality showed promising results but lacked sufficient data for informed conclusions. The overall quality of the studies based on GRADE was medium low to very low. Conclusions Technology interventions can improve social connectedness in older adults. The specific effectiveness rates favor ICT and videoconferencing, but with limited evidence, as indicated by low GRADE ratings. Future intervention and study design guidelines should carefully assess the methodological quality of studies and the overall certainty of specific outcome measures. The lack of randomized controlled trials in underlying primary studies (<28%) and suboptimal methodologies limited our findings. Robotics and augmented or virtual reality warrant further research. Low GRADE scores highlight the need for high-quality research in these areas. Trial Registration PROSPERO CRD42022363475; https://tinyurl.com/mdd6zds

The Impact of Social Isolation, Loneliness, and Technology Use During the COVID-19 Pandemic on Health-Related Quality of Life: Observational Cross-sectional Study

“…Further, technology use is linked to improved self-rated health and psychological well-being, alleviating loneliness among older adults, and encouraging behaviors that may lead to better levels of HRQoL [ 4 ]. Digital communication tools became critical during the pandemic to remain socially connected and helped prevent social health risks [ 5 ], potentially benefiting those with lower HRQoL [ 6 ]. We hypothesized that technology use could predict higher HRQoL (hypothesis 2).…”

The association between information and communication technologies, loneliness and social connectedness: A scoping review

“…Findings from RCTs highlight that the effectiveness of ICT interventions may be more closely related to who is conducting the training, rather than the training duration. Group versus individual based training formats are likely to affect training efficacy ( Ibarra et al, 2020 ; Balki et al, 2022 ). These factors are discussed in more depth in Section 4.3.1.…”

Barriers and facilitators of digital interventions use to reduce loneliness among older adults: a protocol for a qualitative systematic review

“…We systematically searched the PubMed database for current literatures without language or year restrictions, using the terms ‘loneliness’, ‘older adults’, ‘intervention’ and ‘systematic review’. We identified 28 reviews of digital interventions, including 10 scoping reviews,29–3811 systematic reviews (including 7 meta-reviews),22 30 39–47 2 narrative reviews,48 49 2 rapid reviews,50 51 1 umbrella review,52 1 mini-review53 and 1 systematic review of systematic reviews 54. The majority of the reviews aimed to explore the effectiveness of several or all of the digital interventions on reducing loneliness 31 35 36 39 40 45 47–49 52 53.…”

“…We identified 28 reviews of digital interventions, including 10 scoping reviews,29–3811 systematic reviews (including 7 meta-reviews),22 30 39–47 2 narrative reviews,48 49 2 rapid reviews,50 51 1 umbrella review,52 1 mini-review53 and 1 systematic review of systematic reviews 54. The majority of the reviews aimed to explore the effectiveness of several or all of the digital interventions on reducing loneliness 31 35 36 39 40 45 47–49 52 53. The scoping reviews also focused on the classification and mechanisms of action of digital interventions 29–38.…”

“…In addition, high costs,58 60 privacy issues,58 61 internet connectivity and workflow are also factors that are barriers to the implementation of digital technologies in older adults 58 61–63. Currently, two scoping reviews have summarised the barriers and facilitators to the use of two robotic interventions in reducing loneliness in older adults, but there are a lack of summarised evidence of the reasons for the success and barriers of digital interventions aimed at reducing loneliness in older adults 37 52 64…”