NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Addressing Social Isolation To Improve the Health of Older Adults: A Rapid Review
Rapid Evidence Product
Investigators: Stephanie Veazie, M.P.H., Jennifer Gilbert, M.D., M.P.H., Kara Winchell, M.A., Robin Paynter, M.L.I.S., and Jeanne-Marie Guise, M.D., M.P.H.
Structured Abstract
Background:
Social isolation and loneliness in older adults are substantial public health problems. Interventions have been examined for their effect on reducing social isolation and loneliness; however, it is unclear which are effective at improving health outcomes and avoiding unnecessary health care utilization.
Purpose:
To review recent literature evaluating the effectiveness of interventions that target social isolation and loneliness to improve health and/or health care utilization.
Methods:
We used rapid review methods to evaluate recent research. We systematically searched Ovid/Medline®, PsycInfo®, and CINAHL® from 2013 to 2018 for systematic reviews and from 2016 to 2018 for primary studies. We used predetermined criteria to select primary studies from systematic reviews published in 2018, in addition to the primary study search. We extracted study-level data, conducted quality assessments, and synthesized results.
Findings:
Sixteen studies were included: one good-quality randomized controlled trial [RCT], seven fair-quality studies (6 RCTs and 1 pre-post), and eight poor-quality studies (7 pre-post and 1 cross-sectional with post-test survey). Of the eight good- or fair-quality studies, five examined physical activity, two examined social interventions, and one examined an arts and recreation intervention. Two were associated with a positive effect on health outcomes: a resistance training, nutrition, and psychosocial support intervention improved functionality, depression, diet, and social capital, and a physical/leisure activity intervention improved quality of life but not social support. Two interventions (group tai chi and facilitated group discussion) improved loneliness but not health outcomes (e.g. quality of life or depression). Of the four fair- or good-quality studies reporting a positive impact on social isolation or health outcomes, three involved a health care professional in delivery, and three met more than once/week. Most poor-quality studies showed improvement in health but not social isolation; however, study design issues limited the reliability of these results. Five of 16 studies reported on harms and none were clinically significant. Three reported on health care utilization, with conflicting results.
Implications:
Of interventions to reduce social isolation, physical activity interventions show the most promise at improving the health of older adults; however, effects were inconsistent and studies short term. Information on the effect of interventions on health care utilization is sparse and inconsistent. Health systems should target interventions to the needs of their population while keeping in mind that the documented impact of such interventions specific to social isolation, health, and health care utilization outcomes is limited. Health systems should rigorously evaluate their efforts to increase the evidence base and share results with other health care systems.
Contents
- Purpose of Review
- Preface
- Peer Reviewers
- Background
- Methods
- Findings
- Question 1. Among older adults, what is the effectiveness of interventions (volunteerism, peer support, transportation programs, etc.) that target social isolation and loneliness to improve health and reduce unnecessary health care utilization?
- Question 2. Among older adults, what are the harms associated with interventions (volunteerism, peer support, transportation programs, etc.) that target social isolation and loneliness to improve health and reduce unnecessary health care utilization?
- Discussion
- References
- Appendixes
Suggested citation:
Veazie S, Gilbert J, Winchell K, Paynter R, Guise J-M. Addressing Social Isolation To Improve the Health of Older Adults: A Rapid Review. Rapid Evidence Product. (Prepared by Scientific Resource Center under Contract No. 290-2017-00003-C.) AHRQ Publication No. 19-EHC009-EF. Rockville, MD: Agency for Healthcare Research and Quality; February 2019. Posted final reports are located on the Effective Health Care Program search page. DOI: https://doi.org/10.23970/AHRQEPC-RAPIDISOLATION.
This report is based on research conducted by the Scientific Resource Center under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2017-00003-C). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.
The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.
This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.
AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied.
Persons using assistive technology may not be able to fully access information in this report. For assistance contact vog.shh.qrha@cpe.
- NLM CatalogRelated NLM Catalog Entries
- Review Screening for Adolescent Idiopathic Scoliosis: A Systematic Evidence Review for the U.S. Preventive Services Task Force[ 2018]Review Screening for Adolescent Idiopathic Scoliosis: A Systematic Evidence Review for the U.S. Preventive Services Task ForceDunn J, Henrikson NB, Morrison CC, Nguyen M, Blasi PR, Lin JS. 2018 Jan
- Review Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Systematic Review for the U.S. Preventive Services Task Force[ 2017]Review Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Systematic Review for the U.S. Preventive Services Task ForcePatnode CD, Evans CV, Senger CA, Redmond N, Lin JS. 2017 Jul
- Review Lipid Screening in Childhood and Adolescence for Detection of Familial Hypercholesterolemia: A Systematic Evidence Review for the U.S. Preventive Services Task Force[ 2016]Review Lipid Screening in Childhood and Adolescence for Detection of Familial Hypercholesterolemia: A Systematic Evidence Review for the U.S. Preventive Services Task ForceLozano P, Henrikson NB, Dunn J, Morrison CC, Nguyen M, Blasi PR, Anderson ML, Whitlock E. 2016 Aug
- Review Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force[ 2013]Review Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task ForceLin JS, O'Connor E, Rossom RC, Perdue LA, Burda BU, Thompson M, Eckstrom E. 2013 Nov
- Review Primary Care Interventions to Prevent Motor Vehicle Occupant Injuries[ 2007]Review Primary Care Interventions to Prevent Motor Vehicle Occupant InjuriesWilliams S, Whitlock E, Smith P, Edgerton B, Beil T. 2007 Aug
- Addressing Social Isolation To Improve the Health of Older Adults: A Rapid Revie...Addressing Social Isolation To Improve the Health of Older Adults: A Rapid Review
Your browsing activity is empty.
Activity recording is turned off.
See more...