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Cited by 1,463Health disparities and outcomesAging, Health, and DisabilityAging and Gerontology Research

Social isolation, loneliness and health in old age: a scoping review

Open access
Courtin, Emilie, Knapp, Martin·2017·Health & Social Care in the Community
DOI 10.1111/hsc.12311
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Abstract

The health and well-being consequences of social isolation and loneliness in old age are increasingly being recognised. The purpose of this scoping review was to take stock of the available evidence and to highlight gaps and areas for future research. We searched nine databases for empirical papers investigating the impact of social isolation and/or loneliness on a range of health outcomes in old age. Our search, conducted between July and September 2013 yielded 11,736 articles, of which 128 items from 15 countries were included in the scoping review. Papers were reviewed, with a focus on the definitions and measurements of the two concepts, associations and causal mechanisms, differences across population groups and interventions. The evidence is largely US-focused, and loneliness is more researched than social isolation. A recent trend is the investigation of the comparative effects of social isolation and loneliness. Depression and cardiovascular health are the most often researched outcomes, followed by well-being. Almost all (but two) studies found a detrimental effect of isolation or loneliness on health. However, causal links and mechanisms are difficult to demonstrate, and further investigation is warranted. We found a paucity of research focusing on at-risk sub-groups and in the area of interventions. Future research should aim to better link the evidence on the risk factors for loneliness and social isolation and the evidence on their impact on health.

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Crossref · 10.1111/hsc.12311

Cites

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Statistics

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Claims the paper makes

0 of 65 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Most studies (47%) used the UCLA Loneliness scale or its shorter revised version.

    “Most studies (47%) used the UCLA Loneliness scale (Russell 1996) or its shorter revised version.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Russell 1996 source

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  • Findingown data

    Seventeen studies used a single-item question on loneliness.

    “Seventeen studies used a single-item question on loneliness.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Only 23% of studies on loneliness contrasted different dimensions of loneliness.

    “The notion was often considered as unidimensional as only 23% of studies on loneliness contrasted different dimensions, such as sense of belonging or the nature of discrepancies between experienced and expected relationships (e.g.Martina and Stevens 2006); or between social and emotional loneliness (e.g.Dong et al. 2012, Drageset et al. 2013a, b).”
    Quote in the paperNot a substantial claim
  • Findingown data

    2% of papers investigated level of health service use of isolated older people.

    “The level of health service use of isolated older people was investigated in 2% of papers.”
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  • Findingown data

    The vast majority of studies used a quantitative approach.

    “The vast majority used a quantitative approach, with only 5% being qualitative and 3% using mixed methods.”
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  • The quote only partly states this claim. 1

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    Findingown data

    The 128 included studies spanned 15 countries, with half focused on the USA.

    “The papers spanned 15 countries.Half focused on the USA, followed by the UK and the Netherlands.”
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    Findingown data

    54% of included articles were published between 2010 and 2013.

    “Research on the impact of social isolation and loneliness on health constitutes a large and growing body of literature, with 54% of the included articles published between 2010 and 2013 (Figure 2).”
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    Findingown data

    Loneliness and social isolation attract multidisciplinary attention.

    “Loneliness and social isolation attract multidisciplinary attention.First authors' disciplines included medicine, psychology, epidemiology, public health and nursing.”
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    Findingown data

    The scoping review included 128 articles.

    “One hundred and twenty-eight articles were included in the scoping review.”
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    Findingnone given

    Half the studies collected primary data.

    “Half the studies collected primary data.”
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    Findingcitation

    Loneliness was usually defined as an undesirable subjective experience related to unfulfilled intimate and social needs.

    “First, the concept of loneliness was usually defined as an undesirable subjective experience, related to 'unfulfilled intimate and social needs' (Peplau and Perlman 1982).”
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    • cites Peplau and Perlman 1982

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    Findingown data

    10 studies looked at the impact of isolation and loneliness on biomarkers such as cortisol or C-reactive protein, 80% published between 2010 and 2013.

    “It should be noted that a number of studies looked at the impact of isolation and loneliness on biomarkers such as cortisol levels or C-reactive protein (a marker of systemic infection) (10 studies in total; 80% published between 2010 and 2013).”
    Quote in the paperNot a substantial claim

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    Findingown data

    Just over half of the 128 studies included a formal definition of isolation or loneliness, mostly loneliness.

    “Just over half of the 128 studies included a formal definition of isolation or loneliness, mostly the latter.”
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    Findingown data

    53% of the 128 papers focused on loneliness and 21% on social isolation.

    “In terms of the issue studied, 53% of the 128 papers focused on loneliness and 21% on social isolation.”
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    Findingnone given

    Over half of the studies used samples representative of the population.

    “Over half of the studies used samples representative of the population.”
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    Findingown data

    Seven studies used the de Jong Gierveld scale specifically designed to measure loneliness in old age.

    “Seven studies used the de Jong Gierveld scale (1987)specifically designed to measure loneliness in old age.”
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    Findingown data

    The most commonly studied outcome was depression, followed by cardiovascular health.

    “The most commonly studied outcome was depression, followed by cardiovascular health.”
    Quote in the paperSubstantial claim

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    Findingcitation

    Measurement of social isolation was heterogeneous, with most studies using an ad hoc index of marital status, household composition, and number of friends and relatives.

    “Measurement of social isolation was heterogeneous.Most studies used an ad hoc index composed of measures of marital status, household composition and number of friends and relatives (e.g.Coyle andDugan 2012, Stafford et al. 2013), and counts of meetings with relatives (e.g.Tilvis et al. 2012).”
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    Findingown data

    Only 25% of papers investigating depression used longitudinal data, compared to almost half of studies focused on cardiovascular health.

    “Only 25% of papers investigating depression used longitudinal data, compared to almost half of the studies focused on cardiovascular health.”
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    Findingnone given

    Out of 32 papers on depression, 25 looked at its association with loneliness.

    “Out of the 32 papers on depression, 25 looked at its association with loneliness.”
    Quote in the paperNot a substantial claim

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    Findingown data

    In the sample, 75% of studies on depression looked at loneliness, whereas 72% of studies on cardiovascular health investigated social isolation.

    “In our sample, 75% of studies on depression looked at loneliness, whereas 72% of studies on cardiovascular health investigated social isolation.”
    Quote in the paperNot a substantial claim

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    Findingcitation

    Social isolation has been consistently found to be associated with coronary artery disease, chronic heart failure, congestive heart failure, and hospitalisation due to heart failure.

    “Social isolation has been consistently found to be associated with coronary artery disease (Brummett et al. 2001), chronic heart failure (Friedmann et al. 2006), congestive heart failure (Murberg 2004) and hospitalisation due to heart failure (Cene et al. 2012).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
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    • cites Friedmann et al. 2006 source

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    Findingnone given

    Cardiovascular health was the focus of 13% of the studies included in the review.

    “Cardiovascular health was the focus of 13% of the studies included in the review.”
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    Findingcitation

    Two studies researched the impact of loneliness on cardiovascular health, and both reported that loneliness was associated with cardiovascular risk factors.

    “In addition, two studies researched the impact of loneliness on cardiovascular health.Both reported that loneliness was associated with cardiovascular risk factors (Sorkin et al. 2002, Kamiya et al. 2010).”
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    • cites Kamiya et al. 2010 source

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    Findingnone given

    Eleven studies focused on the differential impact of isolation and loneliness, with 75% published since 2010.

    “Eleven studies focused on the differential impact of isolation and loneliness, with 75% published since 2010.”
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    Findingown data

    Although no clear pattern could be discerned due to the small number of studies, mortality and biological processes appeared to be the most commonly studied health outcomes in this area.

    “Although no clear pattern could be discerned due to the small number of studies, mortality and biological processes appeared to be the most commonly studied health outcomes in this area.”
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    Findingcitation

    Other studies have investigated the role of social mechanisms such as perceived togetherness.

    “Other studies have investigated the role of social mechanisms such as perceived togetherness (Tiikkainen and Heikkinen 2005).”
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    Findingnone given

    Among these studies, 54% used longitudinal data.

    “Among these studies, 54% used longitudinal data.”
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    Findingown data

    Associations between social isolation, loneliness and health have received relatively little attention in the intervention literature, and the results of studies were quite modest.

    “Associations between social isolation, loneliness and health have received relatively little attention in the intervention literature, and the results of studies were quite modest.”
    Quote in the paperSubstantial claim

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    Findingnone given

    The findings on gender differences were mixed.

    “The findings were mixed.”
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    Findingown data

    The review found only three studies that focused on health service use of isolated or lonely older people, only one using longitudinal data.

    “We found only three studies that focused on the level of health service use of isolated or lonely older people, only one using longitudinal data.”
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    Findingnone given

    In recent years, differences by socioeconomic or ethnic backgrounds have also started to be investigated.

    “In recent years, differences by socioeconomic or ethnic backgrounds have also started to be investigated.”
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    Findingown data

    In the scoping review, 65 of the included studies (51%) had a first author affiliated with the USA.

    “| USA | 65 | 51 |”
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    Findingnone given

    Isolation and loneliness are multidisciplinary concepts and to date there is no agreement across disciplines as to the best way to define or measure them.

    “Isolation and loneliness are multidisciplinary concepts and to date there is no agreement across disci-plines as to the best way to define or measure them.”
    Quote in the paperSubstantial claim

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    Findingnone given

    The research evidence on associations between social isolation, loneliness and health has significantly expanded since 2000.

    “The research evidence on these associations has significantly expanded since 2000.”
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    Findingnone given

    A growing number of studies are concerned with the differential impacts of loneliness and isolation on health.

    “It should be noted that a growing number of studies are concerned with the differential impacts of loneliness and isolation on health.”
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    Findingown data

    In the scoping review, 10 of the included studies (8%) had a first author affiliated with the UK.

    “| UK | 10 | 8 |”
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    Findingown data

    The majority of available evidence comes from the USA and has focused on loneliness.

    “We found that the majority of the available evidence comes from the USA and has focused on loneliness.”
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    Findingown data

    In the scoping review, 9 of the included studies (7%) had a first author affiliated with the Netherlands.

    “| Netherlands | 9 | 7 |”
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    Findingown data

    In the scoping review, 24 of the included studies (18%) had a first author from Medicine.

    “| Medicine | 24 | 18 |”
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    Findingown data

    In the scoping review, 14 of the included studies (10%) were facility-based.

    “| Facility-based | 14 | 10 |”
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    Findingown data

    In the scoping review, 15 of the included studies (12%) had a first author from Public health.

    “| Public health | 15 | 12 |”
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    Findingown data

    In the scoping review, 4 included studies (3%) used mixed methods.

    “| Mixed methods | 4 | 3 |”
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    Findingown data

    In the scoping review, 63 of the included studies (49%) used secondary data.

    “| Secondary data | 63 | 49 |”
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    Findingown data

    The median sample size among the included studies was 430.

    “| Median | 430 | |”
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    Findingown data

    In the scoping review, 1 included study (1%) had a case-control design.

    “| Case-control | 1 | 1 |”
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    Findingown data

    In the scoping review, 1 included study (1%) had another design.

    “| Other | 1 | 1 |”
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    Findingown data

    In the scoping review, 15 of the included studies (12%) had a first author from Epidemiology.

    “| Epidemiology | 15 | 12 |”
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    Findingown data

    The minimum sample size among the included studies was 6.

    “| Minimum | 6 | |”
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    Findingown data

    In the scoping review, 19 of the included studies (15%) had a first author from Psychology.

    “| Psychology | 19 | 15 |”
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    Findingown data

    In the scoping review, 6 included studies (5%) were qualitative.

    “| Qualitative | 6 | 5 |”
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    Findingown data

    The maximum sample size among the included studies was 44,573.

    “| Maximum | 44,573 | |”
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    Findingown data

    In the scoping review, 13 of the included studies (10%) had a first author from Nursing.

    “| Nursing | 13 | 10 |”
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    Findingown data

    Among the depression studies in the scoping review, 2 (6%) had another design.

    “| Other | 2 | 6 |”
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    Findingown data

    In the scoping review, 1 included study (1%) examined passive death wishes.

    “| Passive death wishes | 1 | 1 |”
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    Findingown data

    Among the depression studies in the scoping review, 2 (6%) used mixed methods.

    “| Mixed methods | 2 | 6 |”
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    Findingown data

    The scoping review identified 121 health outcomes across the included studies.

    “| Total | 121 | 100 |”
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    Findingown data

    Among the depression studies in the scoping review, 1 (3%) was qualitative.

    “| Qualitative | 1 | 3 |”
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    Findingown data

    In the scoping review, 2 included studies (2%) examined substance abuse.

    “| Substance abuse | 2 | 2 |”
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    Findingown data

    In the scoping review, 1 included study (1%) examined an unspecified outcome.

    “| Unspecified | 1 | 1 |”
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    Findingown data

    In the scoping review, 1 included study (1%) examined diabetes.

    “| Diabetes | 1 | 1 |”
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    Findingown data

    In the scoping review, 1 included study (1%) examined anxiety.

    “| Anxiety | 1 | 1 |”
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    Findingown data

    Among the depression studies in the scoping review, 2 (6%) used other scales.

    “| Other scales* | 2 | 6 |”
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    Findingown data

    Some studies in the reviewed literature used a shorter revised version of the UCLA Loneliness Scale (R-UCLA).

    “number of studies use a”
    • Also stated in: § Conclusion · plain
      “shorter revised version”
    • Also stated in: § Conclusion · plain
      “(R-UCLA)”
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    Findingown data

    Among the depression studies in the scoping review, 8 (26%) used the Geriatric Depression Scale.

    “| Geriatric depression scale | 8 | 26 |”
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    Findingown data

    Among the cardiovascular health studies in the scoping review, 2 (13%) used medical records.

    “| Medical records ‡ | 2 | 1 3 |”
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    Findingown data

    The reviewed literature also used other depression scales, including the Zung Depression Scale, the Hamilton Rating Scale for Depression, and the Psychiatric Symptom Index.

    “Other depression scales found in the reviewed literature include for instance the Hamilton Rating Scale for Depression, the Psychiatric Symptom Index or the Zung Depression Scale.”
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    Findingown data

    Among the depression studies in the scoping review, 2 (9%) focused on another topic.

    “| Other | 2 | 9 |”
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    Findingown data

    Among the cardiovascular health studies in the scoping review, 2 (14%) focused on another topic.

    “| Other | 2 | 14 |”
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    Findingnone given

    The UCLA Loneliness Scale or its revised version is a twenty-item instrument in which each item is rated from 1 (never) to 4 (often).

    “Twenty-item scale, with”
    • Also stated in: § Conclusion · plain
      “each item rated from 1”
    • Also stated in: § Conclusion · plain
      “(never) to 4 (often). A”
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    Study design and conductcitation

    The review followed the five-stage scoping study framework by Arksey and O'Malley (2005).

    “We followed the five-stage methodological framework for scoping studies suggested by Arksey and O'Malley (2005): (i) identify the research question; (ii) identify relevant studies; (iii) select studies; (iv) chart the data; and (v) collate, summarise and report the results.”
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    Study design and conductcitation

    The review used a narrative review approach to collect information.

    “We used the 'narrative review' approach to collect similar information on all studies (Pawson 2002).”
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    • cites Pawson 2002 source

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    Premisecitation

    An increasing number of older people live alone and are at risk of social isolation.

    “An increasing number of older people are living alone and are at risk of being socially isolated (Victor et al. 2002, Savikko et al. 2005, Sundstr€ om et al. 2009).”
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    • cites Victor et al. 2002 source

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    • cites Sundstr€ om et al. 2009

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    Study design and conductreasoning

    The review did not predefine social isolation or loneliness in order to compare definitions and measurements in the literature.

    “We did not predefine social isolation or loneliness as we wanted to compare the definitions and associated measurements in the literature as part of our review.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Social isolation is a risk factor for poor health, reduced well-being, mortality, depression, and cognitive decline.

    “Social isolation has been identified as a risk factor for poor health, reduced well-being, mortality (e.g.Patterson andVeenstra 2010, Steptoe et al. 2013), depression (Heikkinen and Kauppinen 2004) and cognitive decline (Wilson et al. 2007).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Patterson andVeenstra 2010

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    Premisecitation

    Depression and cardiovascular disease are major contributors to the burden of disease in old age.

    “We chose this focus because depression and cardio-vascular are major contributors to the burden of disease in old age (Marengoni et al. 2008).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Marengoni et al. 2008 source

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    Premisecitation

    Sjoberg et al. (2013) found that frequency and perception of social contacts were related to depressive symptoms in one Swedish cohort but not in another.

    “Sjoberg et al. (2013) found interesting differences between two Swedish cohorts of older people: frequency and perception of social contacts were related to depressive symptoms in the first cohort but not in the second.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sjoberg et al. 2013 source

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    Premisecitation

    Wilby (2011) found that depressed older people were not socially isolated but were more likely to report contacts than non-depressed respondents.

    “Interestingly, one of the two studies which did not find an association between isolation and health focused on depression: Wilby (2011) found that depressed older people were not socially isolated but were on the contrary more likely to report contacts than non-depressed respondents.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wilby 2011 source

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    Premisecitation

    Cross-lagged panel analysis showed that loneliness predicted subsequent changes in depression but not vice versa.

    “In contrast, cross-lagged panel analysis showed that loneliness predicted subsequent changes in depression but not vice versa (Cacioppo et al. 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cacioppo et al. 2010 source

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    Premisecitation

    Green et al. (2008) found a cross-sectional association between social networks and cognition and functional status in old age, but not a longitudinal association.

    “Green et al. (2008) found a cross-sectional association between social networks and cognition and functional status in old age, but not a longitudinal association.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Green et al. 2008 source

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    Premisecitation

    A befriending programme for older women reported success in attracting lonely older people but not in improving well-being.

    “One of these programmesfocused on older womenreported success in attracting lonely older people but not in improving the well-being of participants (Martina and Stevens 2006).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Martina and Stevens 2006 source

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    Premisecitation

    Routasalo et al. (2009) reported that a large proportion of participants in psychosocial group rehabilitation found new friends and their well-being increased significantly, but their loneliness scores were not affected.

    “Routasalo et al. (2009) reported that a large proportion of participants had found new friends via the programme and that their well-being levels increased significantly.However, their loneliness scores were not affected by taking part in the programme, suggesting that there are other mechanisms at play.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Routasalo et al. 2009 source

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    Premisecitation

    A randomised control trial of restorative home care showed significant improvements in physical function but no changes in perceived social support.

    “A randomised control trial of a model of restorative home care on physical health and social support showed significant improvements in physical function but no changes in perceived levels of social support (Parsons et al. 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Parsons et al. 2013 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Tilvis et al. (2011, 2012) found that groups of older people who are isolated or lonely only partially overlap and that only loneliness (and not social isolation) was an independent mortality risk factor in old age.

    “Tilvis et al. (2011Tilvis et al. ( , 2012) ) found that groups of older people who are isolated or lonely only partially overlap and that only loneliness (and not social isolation) was an independent mortality risk factor in old age.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Tilvis et al. 2011

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    • cites Tilvis et al. 2012 source

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    Premisecitation

    Preliminary results from a randomised control trial suggest that socially disconnected older adults were at considerably higher risk of suicide.

    “The Senior Connection programme fosters peer companionship for older adults, with the aim of reducing suicide risk in later life: preliminary results from a randomised control trial suggest that socially disconnected older adults were at considerably higher risk of suicide (Van Orden et al. 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Van Orden et al. 2013 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Lower levels of isolation and a supportive environment were predictive of receiving preventive home visits for older Danish women but not for their male counterparts.

    “Lower levels of isolation and a supportive environment were predictive of receiving preventive home visits for older Danish women but not for their male counterparts (Avlund et al. 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Avlund et al. 2008 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Kahlbaugh et al. (2011) found that older people who engaged in console games reported lower levels of loneliness, but no difference was found with the control group in life satisfaction or physical activity.

    “Kahl-baugh et al. (2011) measured the effects of playing console games on physical activities, loneliness and mood: older people who engaged in games reported lower levels of loneliness, but no difference was found with the control group in terms of life satisfaction or physical activity.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kahl-baugh et al. 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    A potential explanation is that men and women experience different types of loneliness, with different impacts on their physical and mental health.

    “A potential explanation is that men and women experience different types of loneliness, with different impacts on their physical and mental health (Nummela et al. 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nummela et al. 2011 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Ayalon and Shiovitz-Ezra (2011) found that loneliness is a major risk factor for passive death wishes for people aged 50 and over, but the effect was not noticeable for respondents aged over 75.

    “For instance, Ayalon and Shiovitz-Ezra (2011) found that loneliness is a major risk factor for passive death wishes for people aged 50 and over, but that the effect was not noticeable for respondents aged over 75.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ayalon and Shiovitz-Ezra 2011

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Zebhauser et al. (2013) found that although levels of loneliness were equally distributed among men and women, loneliness had a detrimental impact only on the mental health of men.

    “For example, Zebhauser et al. (2013) found that, although levels of loneliness were equally distributed among men and women in their study, loneliness had a detrimental impact only on the mental health of men.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Zebhauser et al. 2013 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous studies have shown that a single-item measure correlates strongly with more sophisticated scales.

    “Although previous studies have shown that a single-item measure correlates strongly with more sophisticated scales (Victor et al. 2005), recent research has emphasised the importance of contrasting different dimensions of loneliness (Coyle and Dugan 2012).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Victor et al. 2005 source

      Not checked in the free run.

86 of 86

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Loneliness predicts deterioration in mental and physical health as well as elevated risk for early mortality.

    “Evidence shows that loneliness predicts deterioration in mental and physical health as well as elevated risk for early mortality”

    From Adolescent Loneliness and Negative Affect during the COVID-19 Pandemic: The Role of Extraversion and Neuroticism (2023) · cites this paper as Courtin & Knapp, 2017

    The review’s ‘Associations with health outcomes’ section reports loneliness as an independent risk factor for depression in old age and associates it with cardiovascular risk factors. Its ‘Differential impact of isolation and loneliness’ section reports increased mortality risk in some studies but explicitly says the findings are mixed. The claim omits the older-adult scope and presents physical-health deterioration and mortality risk as more uniformly predictive than the review establishes; page numbers are unavailable in our copy. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Social isolation and loneliness have negative mental and physical health consequences.

    “Social isolation and loneliness have been studied extensively over the past four decades, with numerous studies showing that both have negative mental and physical health consequences [1–5].”

    From Examining social isolation and loneliness in combination in relation to social support and psychological distress using Canadian Longitudinal Study of Aging (CLSA) data (2020) · cites this paper as [1]

  • The study used a single-item loneliness question from the CES-D10 depression scale, and similar single-item measures are commonly used in the literature.

    “We therefore used a single-item loneliness question that is part of the CES-D10 depression scale [66]: [Over the past week] “How often did you feel lonely?” (1 = all of the time [5-7days]; 2 = occasionally [3–4 days]; 3 = some of the time [1–2 days]; 4 = rarely or never [less than 1 day]. Similar single-item measures are commonly used in the literature [1].”

    From Examining social isolation and loneliness in combination in relation to social support and psychological distress using Canadian Longitudinal Study of Aging (CLSA) data (2020) · cites this paper as [1]

  • Nine out of 10 reviews of depression prevention trials in children and adolescents report significant reductions in depressive symptoms, generally with small effect sizes.

    “Nine out of 10 reviews of these trials report significant reductions in depressive symptoms, 428-436 generally with small effect sizes.”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [434]

  • Another meta-analysis of school-based depression prevention programmes highlighted 81 RCTs with positive but small effect sizes.

    “Another meta-analysis of school-based depression prevention programmes highlighted 81 RCTs with positive but small effect sizes. 434”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [434]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Four full-text papers are unaccounted for

    Major

    Subtracting the 156 excluded full-text articles from the 288 accessed leaves 132, not the reported 128 included articles.

    Reported 128 · recomputed 132

  • Social-isolation share of depression studies is misstated

    Minor

    The three social-isolation studies are 9.375% of the 32 depression studies, not 16%.

    Reported 16 · recomputed 9.375

  • Mortality percentage in the outcomes table is understated

    Minor

    Six of the 121 studies in Table 4 amount to about 4.96%, which rounds to 5% rather than 4%.

    Reported 4 · recomputed 4.958678

  • Loneliness share of depression studies is misstated

    Minor

    Table 5 lists 26 loneliness-focused studies among the 32 depression studies. Their share is 81.25%, not the table's 75%.

    Reported 75 · recomputed 81.25

  • Depression focus categories omit one study

    Minor

    The three focus counts in Table 5 add to 31, although the paper reports 32 depression studies.

    Reported 32 · recomputed 31

  • Cross-sectional study percentage does not match the review total

    Minor

    The 68 cross-sectional studies are 53.125% of the 128 included studies, rather than 52%.

    Reported 52 · recomputed 53.125

  • Loneliness-focused depression study counts disagree

    Minor

    The narrative says 25 depression papers examined loneliness, while Table 5 lists 26.

7 of 7

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Cattan, 1998, Developing evidence base health promotion for older people: a systematic review and survey of health promotion interventions targeting social isolation and loneliness among older people, Internet Journal of Health Promotion, 13, 1
  2. Theeke, 2010a, A current state of the science on loneliness and the health of older adults, Gerontologist, 50, 3

Cited by

Sorted by citations

Related

Authors
Courtin, E., & Knapp, M.
Affiliations
  • London School of Economics and Political Science; Personal Social Services Research Unit; London UK
  • London School of Economics and Political Science (GB)
ORCID
Knapp, Martin
Venue
Health & Social Care in the Community
Publisher
Wiley
Published
2015-12-28
Volume
25
Issue
3
Pages
799-812
ISSN
0966-0410 (ISSN-L)
DOI
10.1111/hsc.12311
OpenAlex
W292445073
Semantic Scholar
1ade1675abe28ff958e9c1450ba17ee00bf5e998
Cited by
1,463
References
131
Citations by year
2026: 164 · 2025: 175 · 2024: 179 · 2023: 207 · 2022: 219 · 2021: 235 · 2020: 167 · 2019: 62 · 2018: 29 · 2017: 19 · 2016: 4
FWCI
3.27
Type
journal article
Language
en
Open access
Licence
Locations
  • Health & Social Care in the Community (publishedVersion)
  • PubMed (publishedVersion)
  • London School of Economics and Political Science Research Online (London School of Economics and Political Science) (acceptedVersion)
  • London School of Economics and Political Science Research Online (London School of Economics and Political Science) (submittedVersion)
Funders
National Institute for Health Research
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
Keywords
social isolation, loneliness, older adults, health outcomes, depression, cardiovascular health, well-being, causal mechanisms, intervention, risk factors
MeSH terms
Aged, Health Status, Humans, Loneliness, Mental Health, Risk Factors, Social Isolation

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-05.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-05.

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