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

The DOI matches its Crossref record; 131 of the 131 references it cites were found in a registry or an index; none of the 65 sources its claims cite is checked for support yet.

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

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Claims the paper makes

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In the paper
“Most studies (47%) used the UCLA Loneliness scale (Russell 1996) or its shorter revised version.”
§ Social isolation, loneliness and health in old age: a scoping review > Definitions and measurements
What the sources say
- Not checked yetcites Russell 1996 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Across the 128 studies, only two did not find a negative association between social isolation or loneliness and health (Wattanakit et al. 2005, Wilby 2011).”
§ Social isolation, loneliness and health in old age: a scoping review > Associations with health outcomes
What the sources say
- Not checked yetcites Wattanakit et al. 2005 source
- Not checked yetcites Wilby 2011 source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes

Show all 94 claims

Probably not a substantial claim. 58
It may state two separate claims as one. 33
The quote only partly states this claim. 1

In the paper
“First, the concept of loneliness was usually defined as an undesirable subjective experience, related to 'unfulfilled intimate and social needs' (Peplau and Perlman 1982).”
§ Social isolation, loneliness and health in old age: a scoping review > Definitions and measurements
What the sources say
- Not checked yetcites Peplau and Perlman 1982
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > Associations with health outcomes
What the sources say
- Not checked yetcites Brummett et al. 2001 source
- Not checked yetcites Friedmann et al. 2006 source
- Not checked yetcites Murberg 2004 source
Strength:boosted· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > Associations with health outcomes
What the sources say
- Not checked yetcites Sorkin et al. 2002 source
- Not checked yetcites Kamiya et al. 2010 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Other studies have investigated the role of social mechanisms such as perceived togetherness (Tiikkainen and Heikkinen 2005).”
§ Social isolation, loneliness and health in old age: a scoping review > Mechanisms and causal links
What the sources say
- Not checked yetcites Tiikkainen and Heikkinen 2005
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“number of studies use a”
- Also stated in: § Conclusion · plain
  “shorter revised version”
- Also stated in: § Conclusion · plain
  “(R-UCLA)”
§ Social isolation, loneliness and health in old age: a scoping review > Conclusion
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Twenty-item scale, with”
- Also stated in: § Conclusion · plain
  “each item rated from 1”
- Also stated in: § Conclusion · plain
  “(never) to 4 (often). A”
§ Social isolation, loneliness and health in old age: a scoping review > Conclusion
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“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.”
§ Social isolation, loneliness and health in old age: a scoping review > Methods
What the sources say
- Not checked yetcites Arksey and O'Malley (2005) source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“We used the 'narrative review' approach to collect similar information on all studies (Pawson 2002).”
§ Social isolation, loneliness and health in old age: a scoping review > Charting the data, summarising and reporting the findings
What the sources say
- Not checked yetcites Pawson 2002 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > Introduction
What the sources say
- Not checked yetcites Victor et al. 2002 source
- Not checked yetcites Savikko et al. 2005 source
- Not checked yetcites Sundstr€ om et al. 2009
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > Introduction
What the sources say
- Not checked yetcites Patterson andVeenstra 2010
- Not checked yetcites Steptoe et al. 2013 source
- Not checked yetcites Heikkinen and Kauppinen 2004 source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“We chose this focus because depression and cardio-vascular are major contributors to the burden of disease in old age (Marengoni et al. 2008).”
§ Social isolation, loneliness and health in old age: a scoping review > Associations with health outcomes
What the sources say
- Not checked yetcites Marengoni et al. 2008 source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“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.”
§ Social isolation, loneliness and health in old age: a scoping review > Associations with health outcomes
What the sources say
- Not checked yetcites Sjoberg et al. 2013 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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.”
§ Social isolation, loneliness and health in old age: a scoping review > Associations with health outcomes
What the sources say
- Not checked yetcites Wilby 2011 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“In contrast, cross-lagged panel analysis showed that loneliness predicted subsequent changes in depression but not vice versa (Cacioppo et al. 2010).”
§ Social isolation, loneliness and health in old age: a scoping review > Mechanisms and causal links
What the sources say
- Not checked yetcites Cacioppo et al. 2010 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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.”
§ Social isolation, loneliness and health in old age: a scoping review > Mechanisms and causal links
What the sources say
- Not checked yetcites Green et al. 2008 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > Interventions
What the sources say
- Not checked yetcites Martina and Stevens 2006 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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.”
§ Social isolation, loneliness and health in old age: a scoping review > Interventions
What the sources say
- Not checked yetcites Routasalo et al. 2009 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > Interventions
What the sources say
- Not checked yetcites Parsons et al. 2013 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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.”
§ Social isolation, loneliness and health in old age: a scoping review > Differential impact of isolation and loneliness
What the sources say
- Not checked yetcites Tilvis et al. 2011
- Not checked yetcites Tilvis et al. 2012 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > Interventions
What the sources say
- Not checked yetcites Van Orden et al. 2013 source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > Service use
What the sources say
- Not checked yetcites Avlund et al. 2008 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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.”
§ Social isolation, loneliness and health in old age: a scoping review > Interventions
What the sources say
- Not checked yetcites Kahl-baugh et al. 2011
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > At-risk groups
What the sources say
- Not checked yetcites Nummela et al. 2011 source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“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.”
§ Social isolation, loneliness and health in old age: a scoping review > At-risk groups
What the sources say
- Not checked yetcites Ayalon and Shiovitz-Ezra 2011
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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.”
§ Social isolation, loneliness and health in old age: a scoping review > At-risk groups
What the sources say
- Not checked yetcites Zebhauser et al. 2013 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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).”
§ Social isolation, loneliness and health in old age: a scoping review > Discussion
What the sources say
- Not checked yetcites Victor et al. 2005 source
Strength:boosted· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.

86 of 86

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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

Scoping studies: towards a methodological framework
Arksey, H., & O'Malley, L. (2005) · International Journal of Social Research Methodology · doi:10.1080/1364557032000119616 · Cited by 36,742
Social Relationships and Mortality Risk: A Meta-analytic Review
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010) · PLoS Medicine · doi:10.1371/journal.pmed.1000316 · Cited by 7,272 · cited 1×
“It has been argued that health risks associated with isolation and loneliness are equivalent to the well-established detrimental effects of smoking and obesity (Holt-Lunstad et al. 2010).”
Background
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
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
Social isolation, loneliness, and all-cause mortality in older men and women
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1219686110 · Cited by 2,503
Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses.
Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006) · Psychology and Aging · doi:10.1037/0882-7974.21.1.140 · Cited by 2,380
Loneliness: A Source Book of Current Theory, Research and Therapy
Blazer, D. G. (1983) · Journal of Gerontology · doi:10.1093/geronj/38.4.492 · Cited by 2,139
Social disconnectedness, perceived isolation, and health among older adults
Cornwell, E. Y., & Waite, L. J. (2009) · Journal of Health and Social Behavior · doi:10.1177/002214650905000103 · Cited by 2,027
The Meaning of "Aging in Place" to Older People
Wiles, J. L., Leibing, A., Guberman, N., Reeve, J., & Allen, R. E. S. (2011) · The Gerontologist · doi:10.1093/geront/gnr098 · Cited by 1,979
Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the chicago health, aging, and social relations study
Cacioppo, J. T., Hawkley, L. C., & Thisted, R. A. (2010) · Psychology and Aging · doi:10.1037/a0017216 · Cited by 1,757

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Research works printed but not linked: 2

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Theeke, 2010a, A current state of the science on loneliness and the health of older adults, Gerontologist, 50, 3

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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: bronze
doi.org
Licence: doi.wiley.com/10.1002/tdm_license_1 (tdm)
onlinelibrary.wiley.com/termsAndConditions (vor)
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 › Developmental and Educational 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

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

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