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In older people, some types of therapy improved loneliness and social support in long-term care or community settings

Hoang P, King JA, Moore S, et al. Interventions Associated With Reduced Loneliness and Social Isolation in Older Adults: A Systematic Review and Meta-analysis. JAMA Netw Open. 2022 Oct 3;5(10):e2236676.

Review question

In older people, do any types of therapy reduce loneliness and social isolation?

Background

Loneliness and social isolation are common in older adults. Both loneliness and social isolation can increase a person’s risk for serious health conditions, hospitalization, and death.

Reducing loneliness and social isolation and increasing a person’s social support (the support a person receives and their sense of having accessible and quality social ties with social needs being met) may improve their health. It is unclear what types of therapy can meet these needs.

How the review was done

The researchers did a systematic review of studies available up to March 2020. They found 70 randomized controlled trials that included a total of 8259 people.

Key features of the studies were:

• number of people in the studies ranged from 8 to 741;
• people were 55 to 100 years of age, and most were women;
• people lived in long-term care or in the community;
• therapy was provided for 2 weeks to 2 years;
• types of therapy included animal therapy (interacting with a living dog, bird, or robot dog) , cognitive–behavioural therapy (learning new coping skills) and psychotherapy, counselling, exercise therapy (e.g., Tai Chi, social dance, gym-based exercise program, group yoga), occupational therapist–guided interventions (learning how to do activities of daily living safely), music therapy (e.g., choir, rhythm instruments), reminiscence therapy (uses sight, touch, and smell to trigger memories), social interventions (e.g., social group meeting, telephone support, volunteer support), interventions using technology (e.g., using smartphone for video chat, computer training, videoconference with family members, pedometer plus website to track physical activity), other types of therapies, and combinations of therapy types; and
• therapy was compared with other types of therapy or with no therapy.

What the researchers found

People living in long-term care

Compared with control, loneliness was reduced by:

• animal therapy (compared with no therapy) (large reduction);
• exercise therapy (medium reduction);
• reminiscence therapy (compared with no therapy) (large reduction); and
• combined or multi-component therapy (medium reduction).

Compared with control, social isolation was reduced by therapy using technology (large reduction).

People living in the community

Compared with control, loneliness was reduced by:

• exercise therapy (compared with no therapy) (small reduction);
• music therapy (small reduction);
• reminiscence therapy (medium reduction); and
• combined or multi-component therapy (medium reduction).

Compared with control, social support was increased by:

• cognitive–behavioural therapy or psychotherapy (small increase);
• social therapy (large increase); and
• combined or multi-component therapy (small increase).
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Conclusion

In older people, some types of therapy improved loneliness and social support in long-term care and community settings.

Effects of different therapies vs control on loneliness and social support in older people living in long-term care or in the community*

*Only therapies that had an effect on loneliness or social support are reported.