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Home-based strategies may increase social connectedness and reduce loneliness and depressive symptoms in older adults

Chua CMS, Chua JYX, Shorey S. Effectiveness of home-based interventions in improving loneliness and social connectedness among older adults: A systematic review and meta-analysis Aging Ment Health. 2023;28:1-10.

Review question

How effective are home-based strategies at reducing loneliness and depressive symptoms and improving social connectedness in older adults?

Background

Life events and transitions, such as loss of a loved one, retirement, and limited mobility, increase the risk of older adults experiencing loneliness and social isolation. Strategies that aim to address loneliness and social isolation and are offered in community settings may not be accessible to older adults who are isolated at home. Home-based strategies are one potential solution, however, gaps in the research require a systematic review on the topic.     

How the review was done

This is a systematic review and meta-analysis of 14 randomized controlled trials. These studies were published between 1993 and 2021.

Key features of the studies were:

• On average, participants were older adults ranging between the ages of 65 and 81 years old and from one of the following groups: general population, home-bound, suicidal or lonely, migrants, living with chronic diseases, dependent on activities of daily living, and needing long-term care services.
• Participants engaged in one of four different home-based strategies: befriending (e.g., peer home visits), psychological therapies (e.g., cognitive behavioural or reminisce therapies), skill development (e.g., computer training), and provision of health and social care by a professional (e.g., primary home care, occupational therapist led training and education, home visits). 
• Home-based strategies took place daily or weekly, ranged from 30 minutes to four hours in duration, and occurred over five weeks to two years.   
• Researchers measured changes in loneliness, social connectedness (via social-related constructs like social support, engagement, etc.), and depressive symptoms.
• Results were compared with people in control groups receiving standard care, placebo (e.g., telephone support calls/generic calls/friendly visits), and on waitlists (e.g., waiting to receive home-based strategy).  

What the researchers found

In older adults, compared to control groups, home-based strategies may:

• reduce loneliness by a small amount;
• reduce depressive symptoms by a very small amount; and 
• improve overall social connectedness by increasing both social engagement by a large amount and social support by a moderate amount.

The certainty of the evidence is quite low, meaning future research could show different results. More high-quality research is needed to verify the results found here and gain a better understanding of which home-based strategies are best, how these strategies impact various aspects of social connectedness, and long-term impacts.

Conclusion

In older adults, home-based strategies may reduce loneliness and depressive symptoms, while also improving certain aspects of social connectedness.