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Tackling loneliness evidence review
- Authors:
- QUALTER Pamela, et al
- Publisher:
- GREAT BRITAIN. Department for Digital, Culture, Media and Sport
- Publication year:
- 2022
- Pagination:
- 31
- Place of publication:
- London
This report aims to establish the evidence gaps in the field of loneliness, including those related to interventions; examine what existing evidence can be built on and what needs to be developed from first principles; determine which evidence gaps should be prioritised; and establish which pre-existing quantitative datasets could be used to address the prioritised evidence gaps, and identify which prospective cohort studies would be enhanced by inclusion of a measure of loneliness. As well as continuing to improve measurement, the review has identified eight priority areas: life course approach – looking at how loneliness changes over people’s lives; social stigma; societal culture – the impact of a collectivist vs individualistic society; mental health; place and context; workplace; economic evaluation; effectiveness of loneliness interventions. The number of studies examining interventions for loneliness has increased significantly in recent years and is diverse in terms of participant groups and intervention types, although most are for older people and western countries for groups or individuals. There are some school and community-based interventions with broad target groups. Social support and social network intervention strategies are most used because they are group face to face interventions, although digital is increasing. (Edited publisher abstract)
Prevalence of loneliness amongst older people in high-income countries: a systematic review and meta-analysis
- Authors:
- CHAWLA Kavita, et al
- Journal article citation:
- PLoS ONE, 16(7), 2021, Online only
- Publisher:
- Plos Publications
- Place of publication:
- San Francisco, CA
Background and objective: Loneliness is associated with increased rates of morbidity and mortality, and is a growing public health concern in later life. This study aimed to produce an evidence-based estimate of the prevalence of loneliness amongst older people (aged 60 years and above). Study design and setting: Systematic review and random-effects meta-analysis of observational studies from high income countries 2008 to 2020, identified from searches of five electronic databases (Medline, EMBASE, PsychINFO, CINAHL, Proquest Social Sciences Premium Collection). Studies were included if they measured loneliness in an unselected population. Results: Thirty-nine studies reported data on 120,000 older people from 29 countries. Thirty-one studies were suitable for meta-analysis. The pooled prevalence estimate of loneliness was 28.5% (95%CI: 23.9% - 33.2%). In twenty-nine studies reporting loneliness severity, the pooled prevalence was 25.9% (95%CI: 21.6% - 30.3%) for moderate loneliness and 7.9% (95%CI: 4.8% - 11.6%) for severe loneliness (z = -6.1, p < 0.001). Similar pooled prevalence estimates were observed for people aged 65–75 years (27.6%, 95%CI: 22.6% - 33.0%) and over 75 years (31.3%, 95%CI: 21.0% - 42.7%, z = 0.64, p = 0.52). Lower levels of loneliness were reported in studies from Northern Europe compared to South and Eastern Europe. Conclusions: Loneliness is common amongst older adults affecting approximately one in four in high income countries. There is no evidence of an increase in the prevalence of loneliness with age in the older population. The burden of loneliness is an important public health and social problem, despite severe loneliness being uncommon. (Edited publisher abstract)
COVID‐19 in the geriatric population
- Authors:
- ROY Justin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, early cite 3 August 2020,
- Publisher:
- Wiley
Objectives: The global COVID‐19 pandemic has caused rapid and monumental changes around the world. Older people, who already experience higher rates of social isolation and loneliness, are more susceptible to adverse effects as a result of the social distancing protocols enacted to slow the spread of COVID‐19. Based on prior outbreaks, the authors speculate the detrimental outcomes and offer solutions. Methods: Reviewing the literature on the detrimental effects of social isolation and loneliness and higher mortality in the older population. Utilizing psychological study outcomes from prior major outbreaks such as in SARS, Ebola, H1N1 influenza, and Middle East respiratory syndrome offer predictions and the susceptibility in the geriatric age group. Results: Organizations such as the WHO, Centers for Disease Control, and American Association of Retired Persons have put measures in place to provide networking on a local, regional, and national level. These efforts are designed to start mitigating such detrimental effects. A necessary follow‐up to this pandemic will be gathering data on unique populations such as the geriatric community, to better mitigate adverse outcomes given the certainty that COVID‐19 will not be the last global viral outbreak. Conclusions: The results of worsened social isolation and loneliness is associated with significantly increased morbidity and mortality in the geriatric population. Various solutions including virtual interactions with loved ones, engaging in physical activity, continuing any spiritual or religious prayers remotely, and community services to provide aid for the older population are all efforts to minimize social isolation and loneliness. (Edited publisher abstract)
Loneliness and social isolation interventions for older adults: a scoping review of reviews
- Authors:
- FAKOYA Olujoke A., MCCORRY Noleen K., DONNELLY Michael
- Journal article citation:
- BMC Public Health, 20(129), 2020, Online only
- Publisher:
- BioMed Central Ltd
Background: Loneliness and social isolation are growing public health concerns in our ageing society. Whilst these experiences occur across the life span, 50% of individuals aged over 60 are at risk of social isolation and one-third will experience some degree of loneliness later in life. The aim of this scoping review was to describe the range of interventions to reduce loneliness and social isolation among older adults that have been evaluated; in terms of intervention conceptualisation, categorisation, and components. Methods: Three electronic databases (CINAHL, Embase and Medline) were systematically searched for relevant published reviews of interventions for loneliness and social isolation. Inclusion criteria were: review of any type, published in English, a target population of older people and reported data on the categorisation of loneliness and/or social isolation interventions. Data extracted included: categories of interventions and the reasoning underpinning this categorisation. The methodology framework proposed by Arskey and O’Malley and further developed by Levac, et al. was used to guide the scoping review process. Results: A total of 33 reviews met the inclusion criteria, evaluating a range of interventions targeted at older people residing in the community or institutionalised settings. Authors of reviews included in this paper often used the same terms to categorise different intervention components and many did not provide a clear definition of these terms. There were inconsistent meanings attributed to intervention characteristics. Overall, interventions were commonly categorised on the basis of: 1) group or one-to-one delivery mode, 2) the goal of the intervention, and 3) the intervention type. Several authors replicated the categorisation system used in previous reviews. Conclusion: Many interventions have been developed to combat loneliness and social isolation among older people. The individuality of the experience of loneliness and isolation may cause difficulty in the delivery of standardised interventions. There is no one-size-fits-all approach to addressing loneliness or social isolation, and hence the need to tailor interventions to suit the needs of individuals, specific groups or the degree of loneliness experienced. Therefore, future research should be aimed at discerning what intervention works for whom, in what particular context and how. (Edited publisher abstract)
Health and wellbeing consequences of social isolation and loneliness in old age
- Authors:
- COURTIN Emilie, KNAPP Martin
- Publisher:
- NIHR School for Social Care Research
- Publication year:
- 2015
- Pagination:
- 3
- Place of publication:
- London
Summarises the findings of a scoping review which looked at literature on the impact of social isolation and loneliness on physical health, mental health and wellbeing in old age. Searches were conducted on nine databases, retrieving 11,736 articles, of which 128 were included in the scoping review. Almost all the studies reviewed found that isolation and loneliness has a detrimental effect on health. Depression and cardiovascular health were the most often researched outcomes, followed by well-being. Gaps in the evidence base were identified in both the use of health and social care by older people and on interventions to reduce loneliness and isolation. A lack of consistency in the definitions and measures of isolation and loneliness was also found, which limits the ability to compare findings between studies. (Edited publisher abstract)
Primary care-based interventions addressing social isolation and loneliness in older people: a scoping review
- Authors:
- GALVEZ-HERNANDEZ Pablo, PAZ Luis Gonzalez-de, MUNTANER Carles
- Journal article citation:
- BMJ Open, 12(2), 2022, Online only
- Publisher:
- BMJ Publishing Group
Objectives: Primary care is well positioned to identify and address loneliness and social isolation in older adults, given its gatekeeper function in many healthcare systems. This study aimed to identify and characterise loneliness and social isolation interventions and detect factors influencing implementation in primary care. Design: Scoping review using the five-step Arksey and O’Malley Framework. Data sources: MEDLINE, CINAHL, EMBASE, COCHRANE databases and grey literature were searched from inception to June 2021. Eligibility criteria: Empirical studies in English and Spanish focusing on interventions addressing social isolation and loneliness in older adults involving primary care services or professionals. Data extraction and synthesis: The researchers extracted data on loneliness and social isolation identification strategies and the professionals involved, networks and characteristics of the interventions and barriers to and facilitators of implementation. This study conducted a thematic content analysis to integrate the information extracted. Results:32 documents were included in the review. Only seven articles (22%) reported primary care professionals screening of older adults’ loneliness or social isolation, mainly through questionnaires. Several interventions showed networks between primary care, health and non-healthcare sectors, with a dominance of referral pathways (n=17). Two-thirds of reports did not provide clear theoretical frameworks, and one-third described lengths under 6 months. Workload, lack of interest and ageing-related barriers affected implementation outcomes. In contrast, well-defined pathways, collaborative designs, long-lasting and accessible interventions acted as facilitators. Conclusions: There is an apparent lack of consistency in strategies to identify lonely and socially isolated older adults. This might lead to conflicts between intervention content and participant needs. This study also identified a predominance of schemes linking primary care and non-healthcare sectors. However, although professionals and participants reported the need for long-lasting interventions to create meaningful social networks, durable interventions were scarce. Sustainability should be a core outcome when implementing loneliness and social isolation interventions in primary care. (Edited publisher abstract)
How can we reduce the toll of loneliness in older adults?
- Author:
- NATIONAL INSTITUTE FOR HEALTH RESEARCH
- Publisher:
- National Institute for Health Research
- Publication year:
- 2021
- Place of publication:
- London
This alert brings together key findings on loneliness in older adults, to build a picture of what is known, and what is needed, to address the problem. The briefing covers: What is loneliness? How loneliness takes a heavy toll on health; How to address loneliness in the community; How professionals can help people in the community; How families and friends can help; Addressing loneliness in care homes; and How care staff can help. Key messages: research suggests that almost one in three people over 75 – and almost two in three carers of people with dementia - are lonely; the need to see older people as individuals; just two minutes extra with each older patient could make interactions more meaningful. Research also points to difficulties in introducing change. It suggests that care home staff need ongoing support to bring in new programmes to engage elderly residents. Future research will also be needed to explore loneliness among diverse groups in the population. Conclusion: a concerted effort to reduce loneliness in older adults would bring long-term benefits to the physical health of the population. It would also make a difference immediately to those people and their carers. (Edited publisher abstract)
Life in lockdown: social isolation, loneliness and quality of life in the elderly during the COVİD-19 pandemic: a scoping review
- Authors:
- KASAR Kadriye Sayin, KARAMAN Emine
- Journal article citation:
- Geriatric Nursing, early cite 12 March 2021,
- Publisher:
- Elsevier
Coronavirus disease-2019 (COVID-19) had an unprecedented effect all over the world, especially in older individuals. The aim is to evaluate the social isolation, loneliness and quality of life of elderly individuals during the COVID-19 pandemic and to map suggestions to reveal and improve the current situation. This was a scoping review. Articles since December 2019 to March 2021 published on PubMed, Scopus, ProQuest, Cochrane Library, CINAHL databases with the following MeSh terms (‘COVID-19’, ‘coronavirus’, ‘quality of life’ ‘aging’, ‘older people’, ‘elderly’, ‘loneliness’ and ‘social isolation) in English were included. The research, by consensus, resulted in seven studies selected for full reading, including three descriptive and cross-sectional studies, a quasi-experimental study, a pre-post pilot program, an editorial note and a correspondence. In generally, these recommendations were grouped as evaluating the current state of loneliness and isolation in elderly people, making more use of technology opportunities, using cognitive behavioral therapies and different individual intervention components. (Edited publisher abstract)
ESSS Outline: Covid-19, social isolation and loneliness
- Author:
- SAUNDERS Robert C.
- Publisher:
- IRISS
- Publication year:
- 2020
- Pagination:
- 19
- Place of publication:
- Glasgow
This summary provides an overview of recent evidence relating to: Covid-19, social isolation and loneliness. A search for academic research and grey literature identified a range of literature discussing isolation and loneliness, including the mental and physical effects they have, particularly around older people. Literature also suggests interventions that can help mitigate the health and mental health impact of loneliness. However, it found the quality of evidence for the majority of interventions is generally weak. Searches identified material relating to the Covid-19 pandemic and the resulting lockdown in the UK, as well as studies from isolated, confined and extreme environments, and from other pandemics around the world. (Edited publisher abstract)
Older people and social isolation: a review of the evidence
- Author:
- KINSELLA Sarah
- Publisher:
- Wirral Council Business and Public Health Intelligence Team
- Publication year:
- 2015
- Pagination:
- 16
- Place of publication:
- Wirral
A review of the current literature and evidence on effective interventions to tackle social isolation amongst older people. Based on the findings from the review, the report recommends that: interventions should be targeted at those most at-risk; base their activities on the evidence of what works; and focus on providing group activities, particularly those which have an arts, educational learning or social focus and are participatory. It also recommends exploring the use of using new technologies, such as the internet and Skype. (Edited publisher abstract)