Department for Evidence-Based Medicine and Evaluation, University for Continuing Education Krems, Krems an der Donau, Austria.
Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
Eur J Public Health. 2023 Apr 1;33(2):235-241. doi: 10.1093/eurpub/ckad006.
Loneliness and social isolation have comparable health effects to widely acknowledged and established risk factors. Although old people are particularly affected, the effectiveness of interventions to prevent and/or mitigate social isolation and loneliness in the community-dwelling older adults is unclear. The aim of this review of reviews was to pool the findings of systematic reviews (SRs) addressing the question of effectiveness.
Ovid MEDLINE®, Health Evidence, Epistemonikos and Global Health (EBSCO) were searched from January 2017 to November 2021. Two reviewers independently assessed each SR in two consecutive steps based on previously defined eligibility criteria and appraised the methodological quality using a measurement tool to assess SRs 2, AMSTAR 2. One author extracted data from both SRs and eligible studies; another checked this. We conducted meta-analyses to pool the study results. We report the results of the random-effects and common-effect models.
We identified five SRs containing a total of 30 eligible studies, 16 with a low or moderate risk of bias. Our random-effects meta-analysis indicates an overall SMD effect of 0.63 [95% confidence interval (CI): -0.10 to 1.36] for loneliness and was unable to detect an overall effect of the interventions on social support [SMD: 0.00; 95% CI: -0.11 to 0.12].
The results show interventions can potentially reduce loneliness in the non-institutionalized, community-dwelling and older population living at home. As confidence in the evidence is low, rigorous evaluation is recommended.
International Prospective Register of SRs (PROSPERO): Registration number: CRD42021255625.
孤独和社会隔离对健康的影响与广泛认可和既定的风险因素相当。尽管老年人受到的影响尤其大,但在社区居住的老年人中预防和/或减轻社会隔离和孤独感的干预措施的效果尚不清楚。本综述的目的是汇总关于有效性问题的系统评价(SR)的结果。
从 2017 年 1 月至 2021 年 11 月,在 Ovid MEDLINE®、Health Evidence、Epistemonikos 和 Global Health(EBSCO)中进行了检索。两名审查员根据先前定义的纳入标准,分两步独立评估每个 SR,并使用评估 SR 2 的测量工具(AMSTAR 2)评估方法学质量。一名作者从 SR 和合格研究中提取数据;另一名作者对其进行检查。我们进行了荟萃分析以汇总研究结果。我们报告了随机效应和共同效应模型的结果。
我们确定了五项包含 30 项合格研究的 SR,其中 16 项的偏倚风险较低或中度。我们的随机效应荟萃分析表明,孤独感的总体 SMD 效应为 0.63[95%置信区间(CI):-0.10 至 1.36],但干预措施对社会支持的总体效果无法检测到[SMD:0.00;95%CI:-0.11 至 0.12]。
结果表明,干预措施可能会降低非机构化、社区居住和在家居住的老年人的孤独感。由于证据的可信度较低,建议进行严格的评估。
国际前瞻性 SR 注册库(PROSPERO):注册号:CRD42021255625。