Systematic Review of Efficacy of Interventions for Social Isolation of Older Adults

Abstract

Background: The social isolation of older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that ~40% of the population will be aged 50 or above within the next few decades. This systematic review aims to summarize and renew knowledge of the effectiveness of existing interventions for alleviating social isolation of older adults.Methods: Relevant electronic databases, including Cochrane Library, CINAHL, SCOPUS, and Web of Science, were searched by a systematic evaluation method. Eligible randomized controlled trial (RCT) studies were published between 1978 and 2021 in English or Chinese. The primary and secondary outcomes were social isolation and loneliness. The quality of the included RCTs was scored by the Cochrane risk-of-bias tool to assess their quality. Two independent reviewers extracted data, using a standardized form. Narrative synthesis and vote-counting methods were used to summarize and interpret study data.Results: Twenty-four RCTs were finally included in this review. There was evidence of substantial heterogeneity in the interventions delivered. The overall quality of included studies indicated a low-to-medium risk of bias. Eighteen of 24 RCTs showed at least one dimension effect on reducing social isolation. The interventions with accurate targeting of clients in social and public places had more obvious effect. The interventions in which older people are active participants also appeared more likely to be effective. In addition, group intervention activities and individual intervention interviews were effective in improving structural social support; mixed intervention, and group intervention on training support significantly improved functional social support.Conclusions: This study suggests that group and mixed intervention targeting of older adults could be helpful for alleviating social isolation problems. The use of modern technology for remote services could also present good results. More well-conducted RCTs of the effectiveness of social interventions for alleviating social isolation are needed to improve the evidence base. Especially as the debating results of remote interventions, further research in this field should be conducted.

Is equity considered in systematic reviews of interventions for mitigating social isolation and loneliness in older adults?

“…Within the 17 systematic reviews, there were a total of 366 primary studies and a range of 6 to 39 studies per review. We assessed all primary studies from one of the 17 included systematic reviews: the most recent systematic review with a broad intervention scope [ 44 ]. This systematic review included 24 primary studies, however, we included 23 primary studies in our assessment as one study was excluded for not being written in English.…”

“…We identified 17 systematic reviews of effectiveness of interventions which aim to mitigate social isolation and/ or loneliness in older adults [12,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. The characteristics of these reviews are presented in Table 2.…”

The effectiveness of interventions to prevent loneliness and social isolation in the community-dwelling and old population: an overview of systematic reviews and meta-analysis

“…The quality of the SRs was moderate for four SR, 26 , 29–31 low for two 27 , 28 and critically low for two. 27 , 32 The following critical domains were the most common reasons for downgrading: (i) missing a statement that the review methods were established prior to the conduct of the review and (ii) lack of consideration of the risk of bias of individual studies when interpreting/discussing the results and lack of a list of excluded studies to justify the exclusion. To assess the risk of bias of the included SRs, four SRs 26 , 27 , 29 , 32 used the Cochrane Risk of Bias Tool, 34 three 28 , 31 used the Effective Public Health Practice Project tool, 35 one 30 the U.S. Preventive Services Task Force criteria 36 and one the Joanna Briggs Appraisal Checklist.…”

“…This overview of reviews provides a comprehensive summary of the effectiveness of interventions to prevent and/or mitigate the effects of social isolation and loneliness in the non-institutionalized, community-dwelling old people. We identified SRs that assessed the effectiveness of these interventions in general 28 , 30 , 32 , 33 and SRs that assessed specific interventions: promoting social capital, 26 digital gaming and physical exercise,27 technological interventions 31 and physical activity.29 None of these SRs conducted a meta-analysis on the outcomes addressing aspects of social relationships.…”

Pilots for Healthy and Active Ageing (PHArA-ON) Project: Definition of New Technological Solutions for Older People in Italian Pilot Sites Based on Elicited User Needs

“…For Socialisation, the specific need is “To promote social inclusion” with a high priority, which includes reducing isolation and promoting socialization, stopping loneliness and information. Previously, other studies have reported that technological service platforms could develop professional social work vigorously and cooperate with hospital centres in order to address the problem of social isolation of older adults, improve their physical and mental health, as well as quality of life, and promote the healthy aging of the population [ 36 , 37 ].…”