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Rapid Overview
The authors state:
"To rapidly evaluate the effect of interventions targeting social isolation/loneliness in community-dwelling older adults (60 years and older) on outcomes of social isolation/loneliness, health and health care utilization."
The authors state:
"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."
The authors state:
"Preliminary data suggest that coordinating delivery of social determinants of health to high-risk patients through clinical and non-clinical care staff may improve certain health and health care utilization outcomes.
One health system used peers as community health workers for Medicare patients and evaluated the effects on health care utilization outcomes (including emergency department visits, hospital admissions, and annual wellness visits) as well as patient-centered outcomes (e.g., patient satisfaction). In addition, an academic medical center–led initiative is focusing on how technology can facilitate the health and independence, and decrease the social isolation, of older adults.
Another model for addressing social isolation in people of all ages is a company that facilitates creation of relationships through exchange of interests and abilities. Case management services, such as those provided by ElderTree, have also been used to address social support and other health needs of older adults, although that was not the focus of this review.
Social isolation is a complex construct with an unclear relationship to health outcomes, and research should attempt to capture this complexity. Particularly when targeting interventions on health effects, researchers should measure other important personal domains that may be affected by social isolation and are potential intermediaries to health but go beyond simply social interactions such as personal agency, comfort being alone, and/or self-efficacy. With health systems attempting multiple innovative interventions for social determinants of health, we recommend that they rigorously evaluate these interventions and share their data on effectiveness with other health systems."