Abstract：
OBJECTIVE: Loneliness and social isolation are associated with adverse health outcomes, especially within the elderly population, underlining the need for effective interventions. This systematic review and meta-analysis aims to summarize all available evidence regarding the effectiveness of interventions for loneliness and social isolation, to map out their working mechanisms, and to give implications for policy and practice.
METHODS: Systematic literature review and meta-analysis.
METHODS: Older adults (≥65 years).
METHODS: A systematic search was conducted in MEDLINE, PsycINFO, and CINAHL for studies quantitively or qualitatively assessing effects of interventions for loneliness and social isolation in older adults, following predefined selection criteria. Risk of bias as well as small study effects were assessed and, wherever appropriate, information about effect sizes of individual studies pooled using random-effects meta-analyses. Sources for between-study heterogeneity were explored using meta-regression.
RESULTS: Of n = 2223 identified articles, n = 67 were eventually included for narrative synthesis. Significant intervention effects were reported for a proportion of studies (55.9% and 50.0% for loneliness and social isolation, respectively) and 57.6% of studies including a follow-up measure (n = 29) reported sustained intervention effects. Meta-analysis of n = 27 studies, representing n = 1756 participants, suggested a medium overall effect of loneliness interventions (d = -0.47; 95% CI, -0.62 to -0.32). Between-study heterogeneity was substantial and could not be explained by differences in study design, year of publication, outcome measures, intervention length, participant demographics, setting, baseline level of loneliness, or geographic location. However, non-technology-based interventions reported larger effect sizes on average (Δd = -0.35; 95% CI, -0.66 to -0.04; P = .029) and were more often significant. Qualitative assessment of potential intervention mechanisms resulted in 3 clusters of effective components: \"promoting social contact,\" \"transferring knowledge and skills,\" and \"addressing social cognition\".
CONCLUSIONS: Interventions for loneliness and social isolation can generally be effective, although some unexplained between-study heterogeneity remains. Further research is needed regarding the applicability of interventions across different settings and countries, also considering their cost-effectiveness.
METHODS: Systematic literature review and meta-analysis.
METHODS: Older adults (≥65 years).
METHODS: A systematic search was conducted in MEDLINE, PsycINFO, and CINAHL for studies quantitively or qualitatively assessing effects of interventions for loneliness and social isolation in older adults, following predefined selection criteria. Risk of bias as well as small study effects were assessed and, wherever appropriate, information about effect sizes of individual studies pooled using random-effects meta-analyses. Sources for between-study heterogeneity were explored using meta-regression.
RESULTS: Of n = 2223 identified articles, n = 67 were eventually included for narrative synthesis. Significant intervention effects were reported for a proportion of studies (55.9% and 50.0% for loneliness and social isolation, respectively) and 57.6% of studies including a follow-up measure (n = 29) reported sustained intervention effects. Meta-analysis of n = 27 studies, representing n = 1756 participants, suggested a medium overall effect of loneliness interventions (d = -0.47; 95% CI, -0.62 to -0.32). Between-study heterogeneity was substantial and could not be explained by differences in study design, year of publication, outcome measures, intervention length, participant demographics, setting, baseline level of loneliness, or geographic location. However, non-technology-based interventions reported larger effect sizes on average (Δd = -0.35; 95% CI, -0.66 to -0.04; P = .029) and were more often significant. Qualitative assessment of potential intervention mechanisms resulted in 3 clusters of effective components: \"promoting social contact,\" \"transferring knowledge and skills,\" and \"addressing social cognition\".
CONCLUSIONS: Interventions for loneliness and social isolation can generally be effective, although some unexplained between-study heterogeneity remains. Further research is needed regarding the applicability of interventions across different settings and countries, also considering their cost-effectiveness.
摘要：
目的：孤独和社会隔离与不良健康结局相关，特别是在老年人群中，强调需要有效的干预措施。本系统综述和荟萃分析旨在总结有关孤独感和社会隔离干预措施有效性的所有可用证据。来规划他们的工作机制，并对政策和实践产生影响。
方法：系统文献综述和荟萃分析。
方法：老年人（≥65岁）。
方法：在MEDLINE中进行了系统搜索，PsycINFO,和CINAHL用于定量或定性评估老年人孤独感和社会隔离干预措施的影响的研究，遵循预定义的选择标准。评估了偏倚风险和微小的研究效果，在适当的地方，有关使用随机效应荟萃分析汇总的单个研究的效应大小的信息。研究间异质性的来源使用meta回归进行了探索。
结果：在n=2223个确定的文章中，n=67最终被纳入叙事合成。在一定比例的研究中报告了显着的干预效果（孤独和社会孤立分别为55.9％和50.0％，分别）和包括随访措施（n=29）在内的57.6％的研究报告了持续的干预效果。n=27项研究的荟萃分析，代表n=1756名参与者，表明孤独感干预的总体效果中等(d=-0.47；95%CI，-0.62至-0.32)。研究之间的异质性很大，不能用研究设计的差异来解释，出版年份,结果衡量标准，干预长度，参与者人口统计，设置,孤独的基线水平，或地理位置。然而,非基于技术的干预报告平均效应大小较大(Δd=-0.35;95%CI,-0.66~-0.04;P=0.029),且通常更显著.对潜在干预机制的定性评估导致了3组有效组成部分：“促进社会接触，\"\"转移知识和技能，\"和\"解决社会认知\"。
结论：对孤独和社会隔离的干预通常是有效的，尽管研究之间仍然存在一些无法解释的异质性。需要进一步研究干预措施在不同环境和国家的适用性，还考虑到它们的成本效益。
方法：系统文献综述和荟萃分析。
方法：老年人（≥65岁）。
方法：在MEDLINE中进行了系统搜索，PsycINFO,和CINAHL用于定量或定性评估老年人孤独感和社会隔离干预措施的影响的研究，遵循预定义的选择标准。评估了偏倚风险和微小的研究效果，在适当的地方，有关使用随机效应荟萃分析汇总的单个研究的效应大小的信息。研究间异质性的来源使用meta回归进行了探索。
结果：在n=2223个确定的文章中，n=67最终被纳入叙事合成。在一定比例的研究中报告了显着的干预效果（孤独和社会孤立分别为55.9％和50.0％，分别）和包括随访措施（n=29）在内的57.6％的研究报告了持续的干预效果。n=27项研究的荟萃分析，代表n=1756名参与者，表明孤独感干预的总体效果中等(d=-0.47；95%CI，-0.62至-0.32)。研究之间的异质性很大，不能用研究设计的差异来解释，出版年份,结果衡量标准，干预长度，参与者人口统计，设置,孤独的基线水平，或地理位置。然而,非基于技术的干预报告平均效应大小较大(Δd=-0.35;95%CI,-0.66~-0.04;P=0.029),且通常更显著.对潜在干预机制的定性评估导致了3组有效组成部分：“促进社会接触，\"\"转移知识和技能，\"和\"解决社会认知\"。
结论：对孤独和社会隔离的干预通常是有效的，尽管研究之间仍然存在一些无法解释的异质性。需要进一步研究干预措施在不同环境和国家的适用性，还考虑到它们的成本效益。
