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Effects of Psychosocial Group Rehabilitation on Health, Use of Health Care Services, and Mortality of Older Persons Suffering From Loneliness: A Randomized, Controlled Trial
Abstract
BACKGROUND: Loneliness is a distressing feeling of a lack of satisfying human relationships. It is associated with poor quality of life, impaired health, and increased mortality among older individuals. The study aim was to determine the effects of new psychosocial group rehabilitation on the subjective health, use and costs of health services, and mortality of lonely older individuals. METHODS: This randomized, controlled trial was performed in seven day care centers. A total of 235 older people (>74 years) suffering from loneliness participated. Intervention was implemented in 15 groups (each with 7-8 participants and 2 professional group leaders) meeting for 3 months altogether 12 times. Group intervention aimed to empower elderly people, and to promote their peer support and social integration. Intervention was based on the effects of closed-group dynamics. The groups had the following activities according to the participants' interests: (a) therapeutic writing and group psychotherapy, (b) group exercise and discussions, and (c) art activities. Group leaders received thorough training and tutoring. Subjective health, use and costs of health services, and mortality were measured. RESULTS: At 2 years, survival was 97% in the intervention group (95% confidence interval [CI], 91-99) and 90% in the control group (95% CI, 85-95) (p = .047). The intervention group showed a significant improvement in subjective health, thus resulting in significantly lower health care costs during the follow-up: the difference between the groups was -943 euro/person per y (95% CI -1955 to -127; p = .039). CONCLUSIONS: Psychosocial group rehabilitation was associated with lower mortality and less use of health services.
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“The only extant data to address this question comes from a recent study in which 235 lonely home-dwelling older adults (>74 years) were randomly assigned to an intervention or control group.”
From Loneliness matters: a theoretical and empirical review of consequences and mechanisms (2010) · cites this paper as [94]
In the citing paper
“This was accompanied by a significant improvement in self-rated health, fewer health care services and lower costs, and greater survival at 2-year follow-up [94].”
From Loneliness matters: a theoretical and empirical review of consequences and mechanisms (2010) · cites this paper as [94]
In the citing paper
“since the end of our search period (May 2009), new analysis [87] of data derived from a study already included in our review [13] has provided additional evidence suggesting beneficial effects for a psychosocial group intervention.”
From Interventions targeting social isolation in older people: a systematic review (2011) · cites this paper as [87]
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Interventions to address social connectedness and loneliness for older adults: a scoping review
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“Thus, a rational use of existing services might influence the sustainability of interventions and lead to positive outputs, and it would also “resolve” the issue of volunteer participants commonly found across the literature, enabling in that way the intervention to target the intended groups (Pitkala et al., 2009).”
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Older Adults’ Social Relationships and Health Care Utilization: A Systematic Review
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“The 5 studies with a measure of social network all reported findings that showed an inverse relationship between social network size and length of time spent in hospital, though in the case of the 2 studies that used American Longitudinal Study of Aging data, it was contact with nonkin, rather than family members, tha…”
ResultSaito, T., Kai, I., & Takizawa, A. (2012) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2012.04.002 · Cited by 181
“They showed that programs that enhanced relationships between group members had a positive effect on mortality, subjective health (Pitkala et al., 2009), and cognitive health (Pitkala et al., 2011), but no significant effect on loneliness.”
BackgroundLoneliness in Old Age: An Unaddressed Health Problem
Berg‐Weger, M., & Morley, J. E. (2020) · The journal of nutrition health & aging · doi:10.1007/s12603-020-1323-6 · Cited by 165
“5% had dropped out, and 6 of 15 groups were still meeting (24).”
BackgroundSocial capital interventions targeting older people and their impact on health: a systematic review
Coll‐Planas, L., Nyqvist, F., Puig, T., Urrútia, G., Solà, I., & Monteserín, R. (2016) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2016-208131 · Cited by 168
Promoting social capital to alleviate loneliness and improve health among older people in Spain
Coll‐Planas, L., Gómez, G. D. V., Carroza, P. B., Masat, T., Puig, T., & Monteserín, R. (2015) · Health & Social Care in the Community · doi:10.1111/hsc.12284 · Cited by 173
“Contrary to a previous trial, our study did not find a significant decrease in visits to the general practitioner or in hospitalisations (Pitkala et al. 2009).”
MethodResultInfluentialSuffering from Loneliness Indicates Significant Mortality Risk of Older People
Tilvis, R. S., Laitala, V., Routasalo, P. E., & Pitkälä, K. H. (2011) · Journal of Aging Research · doi:10.4061/2011/534781 · Cited by 169
“In fact, psychosocial group intervention in our study population improved health, delayed cognitive decline, reduced all-cause mortality, and diminished the use of health care services of the participants [23].”
BackgroundInfluentialSelf-citationThe economic costs of loneliness: a review of cost-of-illness and economic evaluation studies
Mihalopoulos, C., Le, L. K., Chatterton, M. L., Bucholc, J., Holt‐Lunstad, J., Lim, M. H., & Engel, L. (2019) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-019-01733-7 · Cited by 159
Pitkala, K. H., Routasalo, P., Kautiainen, H., Sintonen, H., & Tilvis, R. S. (2011) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181f7d8b0 · Cited by 139
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Self-citationClinical trials in older people
Pitkälä, K. H., & Strandberg, T. E. (2022) · Age and Ageing · doi:10.1093/ageing/afab282 · Cited by 154
“It is worth using multiple channels to reach potential trial participants, as has been done for studies on the geriatric syndromes of loneliness [15] and frailty [16].”
Shaw, J. G., Farid, M. S., Noël-Miller, C., Joseph, N., Houser, A., Asch, S. M., Bhattacharya, J., & Flowers, L. (2017) · Journal of Aging and Health · doi:10.1177/0898264317703559 · Cited by 142
Cattan, M., Kime, N., & Bagnall, A.-M. (2010) · Health & Social Care in the Community · doi:10.1111/j.1365-2524.2010.00967.x · Cited by 129
“Pitkälä et al. (2009) suggest that it may not be the content of an intervention that defines its effectiveness but rather participants’ sense of control, empowerment and improved sense of mastery.”
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“Causal connections are, however, not excluded, because in persons selected from this population the group rehabilitation aimed at empowering and social activation significantly diminished mortality [30].”
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“In an application of this hypothesis, Pitkala et al. (2009) found that a social intervention reduced lonely older adult’s physician visits and lengths of stay in hospital.”
BackgroundOrellana, K., Manthorpe, J., & Tinker, A. (2018) · Ageing and Society · doi:10.1017/s0144686x18000843 · Cited by 132
“Substantial annual cost savings were estimated as a result of lower use of health services following psycho-social group work (Pitkala et al., 2009), while monitoring of blood pressure at day centres was thought to have the potential to reduce cardiovascular disease and associated costs (Resnick et al.”
BackgroundInfluentialInvesting in mental health and well-being: findings from the DataPrev project
McDaid, D., & Park, A. (2011) · Health Promotion International · doi:10.1093/heapro/dar059 · Cited by 111
“In Finland, a trial of psychosocial group therapy for older people identified to be lonely was also reported to be effective with a net mean reduction in healthcare costs per participant of E943 (Pitkala et al., 2009).”
BackgroundInfluentialLaakkonen, M., Kautiainen, H., Hölttä, E., Savikko, N. M., Tilvis, R. S., Strandberg, T. E., & Pitkälä, K. H. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14055 · Cited by 126
“Problems and need for support services concern both spouses in families of PwD. Costs of PwD and their spouses were calculated in detail.”
BackgroundMethodResultInfluentialSelf-citationLoneliness and the risk of dementia among older Chinese adults: gender differences
Zhou, Z., Wang, P., & Fang, Y. (2017) · Aging & Mental Health · doi:10.1080/13607863.2016.1277976 · Cited by 112
Chinese older adults’ resilience to the loneliness of living alone: A qualitative study
Lou, V. W. Q., & Ng, J. W. (2012) · Aging & Mental Health · doi:10.1080/13607863.2012.692764 · Cited by 95
“Studies on loneliness experiences, coping resources, and intervention evaluation supported the validity of the framework (Eloranta, Routasalo, & Arve, 2008 ; Pitkala, Routasalo, Kautiainen, & Tilvis, 2009 ; Stanley et al, 2010 ).”
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Self-citationEffects of selected leisure activities on preventing loneliness among older Chinese
Teh, J. K. L., & Tey, N. P. (2019) · SSM - Population Health · doi:10.1016/j.ssmph.2019.100479 · Cited by 91
Family Support and Loneliness among Older Persons in Multiethnic Malaysia
Teh, J. K. L., Tey, N. P., & Ng, S. T. (2014) · The Scientific World JOURNAL · doi:10.1155/2014/654382 · Cited by 93
“Loneliness is found to be a precursor to psychological disorders, mental health problems, depression, and even suicide [2, 3, 5, 7–12].”
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“The intensity and longitudinal continuity of services are crucial to achieve psychosocial rehabilitation (Brekke et al., 1999) which are associated with lower mortality and reduced use of health services (Pitkala et al., 2009).”
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“[31] found that social intervention reduced lonely older adults’ physician visits and lengths of stay in the hospital.”
BackgroundUsing Telehealth Groups to Combat Loneliness in Older Adults Through COVID ‐19
Zubatsky, M., Berg‐Weger, M., & Morley, J. E. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16553 · Cited by 75
“One psychosocial intervention that has proven effective and sustainable for this population is called Circle of Friends, an evidence-based intervention to socialize older adults through interactive activities.(6,7) The group protocol meets 12 times over a 3-month period, covering themes that connect lonely people incl…”
BackgroundSocial isolation and loneliness in the elderly: an exploration of some of the issues
Dury, R. (2014) · British Journal of Community Nursing · doi:10.12968/bjcn.2014.19.3.125 · Cited by 77
Improving health and well-being independently of GDP: dividends of greener and prosocial economies
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Effects of social isolation on quality of life in elderly adults
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“Similarly, loneliness has been found to negatively affect both physical and mental health.(2,9,10) Studies find that loneliness is associated with morbidity in terms of cardiovascular diseases, increased inflammatory response, changes to the immune system, Alzheimer’s disease, and depression.”
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“In addition, in the RCT study, 40% of the intervention participants continued meetings on their own one year after the facilitated group (Pitkälä et al., 2009; Savikko et al., 2010).”
BackgroundInfluentialGiebel, C. M., Hassan, S. M., Harvey, G., Devitt, C., Harper, L. M., & Simmill‐Binning, C. (2020) · Health & Social Care in the Community · doi:10.1111/hsc.13228 · Cited by 52
“While other studies have looked into interventions aimed at reducing loneliness and social isolation in older adults (Banks & Banks, 2002; Pitkala et al., 2009; Winstead et al., 2014), Community Connectors exists in the community and slightly varies from tested interventions.”
BackgroundJansson, A. H., Muurinen, S., Savikko, N. M., Soini, H., Suominen, M. H., Kautiainen, H., & Pitkälä, K. H. (2017) · The Journal of Nursing Home Research Sciences · doi:10.14283/jnhrs.2017.7 · Cited by 50
Self-citationA meta-analysis of loneliness and use of primary health care
Sirois, F. M., & Owens, J. (2021) · Health Psychology Review · doi:10.1080/17437199.2021.1986417 · Cited by 61
“One study tested the effect of a loneliness reducing intervention in relation to physician visits, rather than using a loneliness scale (Pitkala et al., 2009), and so was excluded from this moderator analyses.”
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“For example, some authors have indicated that individuals suffering loneliness increase the use and costs of the healthcare system; they visit their general practitioner more frequently, take more medication, and have a higher incidence of falls (Pitkala et al., 2009).”
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“Our primary outcome measure, 15D, is wellvalidated and has worked well in several earlier intervention studies [16,27,29].”
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Ige, J., Gibbons, L., Bray, I., & Gray, S. F. (2019) · BMC Medical Research Methodology · doi:10.1186/s12874-019-0825-6 · Cited by 44
“participants who answered ‘yes’ to a loneliness question on a questionnaire ([21, 22]), one study recruited participants from the general population, and then used a loneliness scale at baseline and follow up to determine loneliness [27].”
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Wan, X., Lighthall, N. R., & Paulson, D. L. (2021) · Computers in Human Behavior · doi:10.1016/j.chb.2021.107064 · Cited by 40
Social isolation and well-being in veterans with mental illness
Grenawalt, T. A., Lu, J., Hamner, K. M., Gill, C., & Umucu, E. (2022) · Journal of Mental Health · doi:10.1080/09638237.2021.2022625 · Cited by 36
“…of correlations between social isolation and depression, functional limitations, and well-being found in the current study echo previous research findings in the literature (Cattan et al., 2005; Findlay, 2003; Greaves & Farbus, 2006; Ha et al., 2019; Mead et al., 2010; Pitkala et al., 2009).”
ResultSharifian, N., Kraal, A. Z., Zaheed, A. B., Sol, K., & Zahodne, L. B. (2020) · Aging & Mental Health · doi:10.1080/13607863.2019.1660850 · Cited by 34
What is the impact of day care on older people with long‐term conditions: A systematic review
Lunt, C., Dowrick, C. F., & Lloyd‐Williams, M. (2020) · Health & Social Care in the Community · doi:10.1111/hsc.13245 · Cited by 38
Coll‐Planas, L., Carbó, A., Jansson, A. H., Dostálová, V., Bártová, A., Rautiainen, L. J., Kolster, A., Masó-Aguado, M., Briones‐Buixassa, L., Alias, S. B., et al. (2024) · BMC Public Health · doi:10.1186/s12889-023-17547-x · Cited by 36
“Participants would screen positive when answering ‘sometimes’ or ‘often, or always’ but not if they say, ‘never or hardly ever’ [12].”
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“We will use randomized controlled trials in Barcelona, Helsinki, and Prague and pre-post intervention studies in Cuenca, Marseille, and Melbourne.”
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“A systematic review of intervention studies published in English before 2009 [5] showed that group-based or individual interventions offering social activities or support groups among socially isolated older people improved at least one positive outcome, such as decreased loneliness [13], increased perceived social su…”
BackgroundMajmudar, I. K., Mihalopoulos, C., Brijnath, B., Lim, M. H., Hall, N. Y., & Engel, L. (2022) · Quality of Life Research · doi:10.1007/s11136-021-03063-1 · Cited by 33
Roswiyani, R., Kwakkenbos, L., Spijker, J., & Witteman, C. L. M. (2017) · Journal of Applied Gerontology · doi:10.1177/0733464817743332 · Cited by 34
“Pitkala et al. (2009) investigated the effect of rehabilitation conducted in a new psychosocial group on subjective health, use and cost of the health services, and mortality of lonely older individuals.”
InfluentialA socialization intervention in remote health coaching for older adults in the home
Jimison, H. B., Klein, K. A., & Marcoe, J. (2013) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2013.6611175 · Cited by 29
Current Trends and Future Directions in Urban Social Prescribing
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Loneliness in assisted living facilities: An exploration of the group process
Jansson, A. H., Karisto, A., & Pitkälä, K. H. (2019) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2019.1690043 · Cited by 26
“A randomised controlled trial found it to be effective in improving older people’s quality of life, health and cognition [29].”
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Flatt, J. D., & Hughes, T. F. (2013) · Aging Health · doi:10.2217/ahe.13.11 · Cited by 31
Direct Costs of Very Old Persons with Subsyndromal Depression: A 5-Year Prospective Study
Ludvigsson, M., Bernfort, L., Marcusson, J. O., Wressle, E., & Milberg, A. (2018) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2018.03.007 · Cited by 18
“Further, the findings that loneliness, presence of SSD, and somatic multimorbidity all predict higher healthcare costs are similar as in previous studies (7, 9, 10, 16) even though the explanatory power for the regression model as well as for the individual variables was small.”
BackgroundResultDouglas, N., Archer, B., Azios, J. H., Strong, K. A., Simmons‐Mackie, N. N., & Worrall, L. E. (2022) · Disability and Rehabilitation · doi:10.1080/09638288.2022.2117866 · Cited by 18
Health-related quality of life as a predictor of mortality in heterogeneous samples of older adults
Liira, H., Mavaddat, N., Eineluoto, M., Kautiainen, H., Strandberg, T. E., Suominen, M. H., Laakkonen, M., Eloniemi-Sulkava, U. R., Sintonen, H., & Pitkälä, K. H. (2018) · European Geriatric Medicine · doi:10.1007/s41999-018-0029-3 · Cited by 17
Self-citationKoistinen, P., Elo, S., Ahlroth, M., Kokko, J., Suistio, S., Kujala, V. M., Naarala, M., & Rissanen, T. (2012) · European Geriatric Medicine · doi:10.1016/j.eurger.2012.09.007 · Cited by 17
“More prospective data are needed about interventions for prevention of and early interference in disability risks in older people in order to maintain and improve quality of life and cost-effectives as well [17–22].”
BackgroundHealth Care Utilization Following Interventions to Improve Social Well-Being
HaGani, N., Surkalim, D. L., Clare, P. J., Merom, D., Smith, B. J., & Ding, D. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.21019 · Cited by 17
Circle of Friends, an Encouraging Intervention for Alleviating Loneliness
Jansson, A. H., & Pitkälä, K. H. (2021) · The journal of nutrition health & aging · doi:10.1007/s12603-021-1615-5 · Cited by 17
“In the randomized controlled trial, the Circle of Friends improved lonely older people’s health, cognition and wellbeing, reduced the use of health care services and mortality among the participants (7, 19, 21).”
BackgroundMethodSocial relationships and the importance of community-based fitness programs (CBFP)
Barragan, C. (2021) · Journal of Women & Aging · doi:10.1080/08952841.2021.1915685 · Cited by 15
“Relationships formed within community-based walking groups also extend beyond the parameters of the group (Pitkala et al., 2009).”
BackgroundLaakkonen, M., Savikko, N. M., Hölttä, E., Tilvis, R. S., Strandberg, T. E., Kautiainen, H., & Pitkälä, K. H. (2013) · European Geriatric Medicine · doi:10.1016/j.eurger.2013.09.006 · Cited by 12
Self-citationCultural plan model: integrating cultural and creative activities into care units for the elderly
Koponen, T., Honkasalo, M., & Rautava, P. T. (2017) · Arts & Health · doi:10.1080/17533015.2017.1315436 · Cited by 15
Larzelere, M., Campbell, J., & Adu-Sarkodie, N. Y. (2011) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2011.07.009 · Cited by 13
Voice assistants’ influence on loneliness in older adults: a systematic review
Martínez, E. C., Encuentra, E. H., & Pousada, M. (2024) · Disability and Rehabilitation Assistive Technology · doi:10.1080/17483107.2024.2397030 · Cited by 12
“…be taken into account. it is vital to conduct more studies with uniform designs, extended durations, and broader samples to overcome the limitations of less rigorous methods such as quasi-experimental designs that lack control groups and do not perform pre-and post-intervention assessments [53].”
Restorative Environment Design Drives Well-Being in Sustainable Elderly Day Care Centres
Li, Y., Lin, X., Li, S., Huang, M., Ren, Z., & Song, Q. (2025) · Buildings · doi:10.3390/buildings15050757 · Cited by 10
Kolster, A., Rautiainen, L. J., Aalto, U. L., Jansson, A. H., Partonen, T., Sachs, A. L., Litt, J., Masó-Aguado, M., & Pitkälä, K. H. (2025) · Geriatric Nursing · doi:10.1016/j.gerinurse.2025.03.061 · Cited by 10
O’Rourke, H. M., Sidani, S., Chu, C. H., Fox, M. T., McGilton, K. S., & Collins, J. (2017) · Gerontology and Geriatric Medicine · doi:10.1177/2333721417734672 · Cited by 10
Christensen, H. K., Kristensen, T., Andersen, M. K. K., & Lykkegaard, J. (2016) · Family Practice · doi:10.1093/fampra/cmw110 · Cited by 10
Relational Processes in Social Anxiety Disorder
Alden, L. E., Regambal, M. J., & Plasencia, L. (2014) · Wiley eBooks · doi:10.1002/9781118653920.ch8 · Cited by 13
Depression and Loneliness Among the Elderly Poor
Banerjee, A., Duflo, E., Grela, E., McKelway, M., Schilbach, F., Sharma, G., & Vaidyanathan, G. (2022) · National Bureau of Economic Research · doi:10.3386/w30330 · Cited by 10
Pitkälä, K. H., Rautiainen, L. J., Aalto, U. L., Kautiainen, H., Kolster, A., Laakkonen, M., Partonen, T., Roitto, H., Strandberg, T. E., Opačin, N., et al. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-05408-0 · Cited by 11
“In our previous trial targeted on home-welling lonely older people, only 2.5% dropped out from the intervention group [17].”
BackgroundInfluentialSelf-citationDomènech‐Abella, J., Díaz-Cofine, S., Rubio-Valera, M., & Aznar‐Lou, I. (2022) · Revista Española de Geriatría y Gerontología · doi:10.1016/j.regg.2022.04.005 · Cited by 12
Campion, J. (2018) · Springer eBooks · doi:10.1007/978-3-319-70554-5_31 · Cited by 9
Satorres, E., Delhom, I., Llopis, J., Navarro, A., Bueno, C., & Meléndez, J. C. (2024) · Social Work in Health Care · doi:10.1080/00981389.2024.2386277 · Cited by 10
“This program establishes a supportive network for individuals at risk of loneliness by promoting regular social interactions and fostering a sense of belonging within a community (Jansson et al., 2018; Pitkala et al., 2009).”
van Woerden, H., Angus, N. J., Kiparoglou, V., Atherton, I., & Leung, J. (2021) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s317393 · Cited by 9
“Similarly, in selected groups, arts-based community activities have been shown to significantly reduce the need for acute hospital care.(32) Health and social care systems have a growing challenge in supporting an elderly and lonely population who have long-term conditions or disability, who have high care needs.”
BackgroundThe effect of geriatric rehabilitation on physical performance and pain in men and women
Niemelä, K., Leinonen, R., & Laukkanen, P. (2010) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2010.09.006 · Cited by 8
Zubatsky, M. (2021) · The journal of nutrition health & aging · doi:10.1007/s12603-021-1584-8 · Cited by 8
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La prescripción social en España: el ejemplo de Cataluña
González, J. C., Martín, M. J., Farran, J. C., & Gónzalez-Viana, A. (2021) · FMC - Formación Médica Continuada en Atención Primaria · doi:10.1016/j.fmc.2021.02.003 · Cited by 9
Nakashima, D., Fujii, K., Kubo, Y., & Yorozuya, K. (2023) · Occupational Therapy International · doi:10.1155/2023/9505865 · Cited by 8
Pitkälä, K. H., Rautiainen, L. J., Kautiainen, H., Aalto, U. L., Kolster, A., Laakkonen, M., Partonen, T., Roitto, H., Puntscher, S., Rochau, U., et al. (2026) · Age and Ageing · doi:10.1093/ageing/afag009 · Cited by 6
Self-citationO’Rourke, H. M., Hopper, T. L., Bartel, L., Archibald, M. M., Hoben, M., Swindle, J., Thibault, D., & Whynot, T. (2021) · Healthcare · doi:10.3390/healthcare9050570 · Cited by 10
Evidence-based campaigning on loneliness in older age: an update from the Campaign to End Loneliness
Goodman, A., & Symons, M. (2013) · Working with Older People · doi:10.1108/wwop-08-2013-0018 · Cited by 6
Metadata
- Authors
- Pitkala, K. H., Routasalo, P., Kautiainen, H., & Tilvis, R. S.
- Affiliations
- Helsinki University Hospital (FI)
- Reumasäätiön sairaala (FI)
- ORCID
- Kautiainen, H.
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-02-17
- Volume
- 64A
- Issue
- 7
- Pages
- 792-800
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2098046307
- Cited by
- 183
- References
- 49
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 15 · 2023: 11 · 2022: 18 · 2021: 18 · 2020: 11 · 2019: 10 · 2018: 13 · 2017: 13 · 2016: 9 · 2015: 9 · 2014: 11 · 2013: 5 · 2012: 5
- FWCI
- 7.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Life-span and Life-course Studies › Aging, Elder Care, and Social Issues
- Keywords
- loneliness, older adults, psychosocial group intervention, group therapy, social integration, peer support, mortality, health care utilization, health care costs, self-rated health, daycare centers, therapeutic writing, art activities, group exercise
- MeSH terms
- Aged, Aging, Female, Finland, Health Services for the Aged, Health Status, Humans, Interpersonal Relations, Loneliness, Male, Psychotherapy, Group, Risk Factors, Survival Analysis, Health Care Costs
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