Family physician at St Michael's Hospital and Baycrest in Toronto, Ont, and Assistant Professor and Program Director of the Care of the Elderly Enhanced Skills Program in the Department of Family and Community Medicine at the University of Toronto.
Locum physician in the Department of Family and Community Medicine at St Michael's Hospital and a hospitalist at the Centre for Addiction and Mental Health and for Inner City Health Associates in Toronto.
Can Fam Physician. 2020 Mar;66(3):176-182.
To review the problems of social isolation, loneliness, and social vulnerability in older adults and the associated risks, and to help primary care providers identify patients at risk and recommend effective interventions.
PubMed and PsycINFO searches were conducted using the terms and and associated key words for relevant English-language articles. References of identified articles were also hand searched. A separate search of the gray literature using Google was conducted to find policy documents and knowledge translation materials from relevant organizations. The search covered relevant articles from the 10 years before June 2019.
Social isolation, loneliness, and social vulnerability are very common in older adults and are associated with considerable morbidity and mortality, comparable to established risk factors such as smoking, alcohol consumption, obesity, and frailty. Numerous interventions addressing loneliness and social isolation have been studied: social facilitation (including technology), exercise, psychological therapies, health and social services, animal therapy, befriending, and leisure and skill development. However, current evidence of effectiveness is limited. A patient-centred approach is essential to the selection of interventions. The needs of underserviced and marginalized populations, including new immigrants, older adults identifying as LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning, and related communities), Indigenous seniors, and seniors living in poverty, as well as the needs of long-term care residents and older caregivers, require further evaluation.
Social isolation, loneliness, and social vulnerability are common problems in older adults and have important health consequences. Family physicians are uniquely positioned to identify lonely and socially isolated older adults and to initiate services.
综述老年人社会隔离、孤独和社会脆弱相关问题及其风险，并帮助初级保健提供者识别有风险的患者，推荐有效的干预措施。
使用术语 和 及其相关关键词，在 PubMed 和 PsycINFO 中进行检索，查找相关英文文章。还对已确定文章的参考文献进行了手工检索。在 Google 上进行了单独的灰色文献搜索，以查找相关组织的政策文件和知识转化材料。检索涵盖了 2019 年 6 月前 10 年的相关文章。
老年人中普遍存在社会隔离、孤独和社会脆弱问题，它们与相当大的发病率和死亡率相关，与已确立的风险因素（如吸烟、饮酒、肥胖和虚弱）相当。已经研究了许多针对孤独和社会隔离的干预措施：社会促进（包括技术）、运动、心理治疗、卫生和社会服务、动物治疗、交友、休闲和技能发展。然而，目前的有效性证据有限。选择干预措施时，以患者为中心的方法至关重要。包括新移民、认同 LGBTQ+（女同性恋、男同性恋、双性恋、跨性别、酷儿或疑问、以及相关群体）的老年人、原住民老年人和生活贫困的老年人在内的服务不足和边缘化人群，以及长期护理居民和老年护理者的需求，需要进一步评估。
社会隔离、孤独和社会脆弱是老年人常见的问题，对健康有重要影响。家庭医生在识别孤独和社会隔离的老年人并启动服务方面具有独特的地位。
