Interventions that successfully target social isolation and loneliness among older people share common features

Gardiner C, Geldenhuys G, Gott M Interventions to reduce social isolation and loneliness among older people: An integrative review Health and Social Care in the Community. 2018;26(2):147-157

Review question

·      What approaches can be taken to effectively address social isolation and loneliness among older adults and what are their key features?

Background

·      Social isolation and loneliness are prevalent issues among older people. They are associated with numerous health outcomes such as depression, cardiovascular disease, as well as overall lower quality of life.

·      Policymakers and various stakeholder groups have acknowledged the need to address this problem among older adults by launching public campaigns and implementing health and social care policies. However, it remains unclear what are the factors that determine the success of these initiatives.

·      This review examined interventions that aim to alleviate social isolation and loneliness and grouped them into six categories: social facilitation interventions, psychological therapies, health and social care provision, animal interventions, befriending interventions and leisure/skill development interventions.

How the review was done

·      A detailed search of a number of electronic databases was conducted for studies published between 2003 to 2016. Studies that focused on loneliness, social isolation, prevention and reduction were included in the review.

·      A total of 2,420 studies were identified in searches, and 39 were included in the review after assessments for eligibility.

·      This review was funded by the Hope Foundation in New Zealand.

What the researchers found

·      This review found that interventions in group settings were not more effective than solitary or one-to-one interactions in contrast to previous research. Some therapies were even found to be more effective when provided individually.

·      Older adults who are housebound are at a greater risk of loneliness and social isolation than the general population. It can be a challenge to target this group, which stresses the need for more innovative solitary activities.

·      Activities and interventions which centered on active, productive engagement were associated with better outcomes over passive activities and those that lacked direction and purpose.

Conclusion

·      This review found that most interventions included were successful to a degree in targeting social isolation and/or loneliness. Three main characteristics common across successful interventions consisted of adaptability, a community development approach and productive engagement.

·      More research is required to evaluate the cost-effectiveness of these different approaches and support understanding on their underlying mechanisms.