Interventions Associated With Reduced Loneliness and Social Isolation in Older Adults: A Systematic Review and Meta-analysis
Open accessAbstract
Importance: Loneliness and social isolation are public health concerns faced by older adults due to physical, cognitive, and psychosocial changes that develop with aging. Loneliness and social isolation are associated with increased morbidity and mortality. Objective: To evaluate interventions, targeting older adults, associated with a reduction in loneliness and social isolation. Data Sources: OVID, CINAHL, CENTRAL, Embase, PsychINFO, Web of Science, and Scopus were searched from inception to March 2020. Study Selection: Peer-reviewed randomized clinical trials measuring loneliness and social isolation or support in adults aged 65 years or older. Only English language articles were included. Data Extraction and Synthesis: Two independent reviewers screened studies, extracted data, and assessed risk of bias. Random-effects models were performed to pool the overall effect size by intervention. Statistical heterogeneity was evaluated with the I 2 statistic and by estimating prediction intervals. Data were analyzed from November 2021 to September 2022. Main Outcomes and Measures: Quantitative measures of loneliness, social isolation, or social support based on an effect size of standardized mean differences. Results: Seventy studies were included in the systematic review (8259 participants); 44 studies were included in the loneliness meta-analysis (33 in the community with 3535 participants; 11 in long-term care with 1057 participants), with participants’ ages ranging from 55 to 100 years. Study sizes ranged from 8 to 741 participants. Interventions included animal therapy, psychotherapy or cognitive behavioral therapy, multicomponent, counseling, exercise, music therapy, occupational therapy, reminiscence therapy, social interventions, and technological interventions. Most interventions had a small effect size. Animal therapy in long-term care, when accounting for studies with no active controls, had the largest effect size on loneliness reduction (−1.86; 95% CI, −3.14 to −0.59; I 2 = 86%) followed by technological interventions (videoconferencing) in long-term care (−1.40; 95% CI, −2.37 to −0.44; I 2 = 70%). Conclusions and Relevance: In this study, animal therapy and technology in long-term care had large effect sizes, but also high heterogeneity, so the effect size’s magnitude should be interpreted with caution. The small number of studies per intervention limits conclusions on sources of heterogeneity. Overall quality of evidence was very low. Future studies should consider measures of social isolation in long-term care and identify the contextual components that are associated with a reduction in loneliness.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283 · see citing works
Statistical Power Analysis for the Behavioral Sciences
Cohen, J. (2013) · doi:10.4324/9780203771587 · Cited by 25,373 · see citing works
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · see citing works
UCLA loneliness scale (version 3): reliability, validity, and factor structure
Russell, D. W. (1996) · Journal of Personality Assessment · doi:10.1207/s15327752jpa6601_2 · Cited by 5,800 · see citing works
Loneliness matters: a theoretical and empirical review of consequences and mechanisms
Hawkley, L. C., & Cacioppo, J. T. (2010) · Annals of Behavioral Medicine · doi:10.1007/s12160-010-9210-8 · Cited by 4,782 · see citing works
A Re-Evaluation of Random-Effects Meta-Analysis
Higgins, J. P. T., Thompson, S. G., & Spiegelhalter, D. J. (2009) · Journal of the Royal Statistical Society Series A: Statistics in Society · doi:10.1111/j.1467-985x.2008.00552.x · Cited by 2,569 · see citing works
A Meta-Analysis of Interventions to Reduce Loneliness
Masi, C. M., Chen, H.-Y., Hawkley, L. C., & Cacioppo, J. T. (2011) · Personality and Social Psychology Review · doi:10.1177/1088868310377394 · Cited by 1,995 · see citing works
Doing Meta-Analysis with R: A Hands-On Guide
Harrer, M., Cuijpers, P., Furukawa, T. A., & Ebert, D. D. (2021) · doi:10.1201/9781003107347 · Cited by 1,850 · see citing works
Wang, J., Mann, F., Lloyd-Evans, B., Ma, R., & Johnson, S. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1736-5 · Cited by 1,494 · see citing works
The Development of a Rasch-Type Loneliness Scale
de Jong-Gierveld, J., & Kamphuls, F. (1985) · Applied Psychological Measurement · doi:10.1177/014662168500900307 · Cited by 1,291 · see citing works
The Psychosocial Effects of a Companion Robot: A Randomized Controlled Trial
Robinson, H., MacDonald, B., Kerse, N., & Broadbent, E. (2013) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.02.007 · Cited by 546 · see citing works
White, H., McConnell, E., Clipp, E., Branch, L. G., Sloane, R., Pieper, C., & Box, T. L. (2002) · Aging & Mental Health · doi:10.1080/13607860220142422 · Cited by 387 · see citing works
'It's just like you talk to a friend': relational agents for older adults
Bickmore, T. W., Caruso, L., Clough-Gorr, K., & Heeren, T. (2005) · Interacting with Computers · doi:10.1016/j.intcom.2005.09.002 · Cited by 341 · see citing works
Hynynen, S.-T., van Stralen, M. M., Sniehotta, F. F., Araújo-Soares, V., Hardeman, W., Chinapaw, M. J. M., Vasankari, T., & Hankonen, N. (2016) · International Review of Sport and Exercise Psychology · doi:10.1080/1750984x.2015.1081706 · Cited by 253 · see citing works
Tsai, H.-H., & Tsai, Y.-F. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1678 · Cited by 167 · see citing works
Fostering Social Ties Through A Volunteer Role: Implications For Older-Adults' Psychological Health
Rook, K. S., & Sorkin, D. H. (2003) · The International Journal of Aging and Human Development · doi:10.2190/nbbn-eu3h-4q1n-uxhr · Cited by 105 · see citing works
Creating New Technologies for Companionable Agents to Support Isolated Older Adults
Sidner, C. L., Bickmore, T., Nooraie, B., Rich, C., Ring, L., Shayganfar, M., & Vardoulakis, L. (2018) · ACM Transactions on Interactive Intelligent Systems · doi:10.1145/3213050 · Cited by 89 · see citing works
Improved self-management ability and well-being in older women after a short group intervention
Kremers, I. P., Steverink, N., Albersnagel, F. A., & Slaets, J. P. J. (2006) · Aging & Mental Health · doi:10.1080/13607860600841206 · Cited by 86 · see citing works
Tse, M. M. Y., Tang, S. K., Wan, V. T. C., & Vong, S. K. S. (2014) · Pain Management Nursing · doi:10.1016/j.pmn.2013.08.003 · Cited by 79 · see citing works
Technology and aging project: training outcomes and efficacy from a randomized field trial
Woodward, A. T., Freddolino, P. P., Blaschke-Thompson, C. M., Wishart, D. J., Bakk, L., Kobayashi, R., & Tupper, C. (2011) · Ageing International · doi:10.1007/s12126-010-9074-z · Cited by 70 · see citing works
Nelson, C. J., Saracino, R. M., Roth, A. J., Harvey, E., Martin, A., Moore, M., Marcone, D., Poppito, S. R., & Holland, J. (2019) · Psycho-Oncology · doi:10.1002/pon.4907 · Cited by 41 · see citing works
Flagged first, then by citations
- Authors
- Hoang, P., King, J. A., Moore, S., Moore, K., Reich, K., Sidhu, H., Tan, C. V., Whaley, C., & McMillan, J.
- Affiliations
- University of Toronto (CA)
- Alberta Health Services (CA)
- University of Calgary (CA)
- McMaster University (CA)
- Corresponding author
- Hoang, Peter
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2022-10-17
- Volume
- 5
- Issue
- 10
- Pages
- e2236676
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC9577679
- OpenAlex
- W4306663560
- Cited by
- 315
- References
- 21
- Citations by year
- 2026: 124 · 2025: 106 · 2024: 60 · 2023: 25
- FWCI
- 6.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JAMA Network Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Health Professions › General Health Professions › Aging, Elder Care, and Social Issues
- Keywords
- loneliness, social isolation, older adults, intervention, animal-assisted therapy, videoconferencing, long-term care, social support, reminiscence therapy, music therapy, occupational therapy, cognitive behavioral therapy, physical activity, social intervention, technology-based interventions, community-dwelling older adults, aging, psychosocial interventions, effect size heterogeneity, risk of bias, low-quality evidence
- MeSH terms
- Loneliness, Psychotherapy, Social Isolation, Exercise, Cognitive Behavioral Therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
