North York General Hospital, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
BMC Geriatr. 2024 Jun 15;24(1):521. doi: 10.1186/s12877-024-05096-w.
The impact of social frailty on older adults is profound including mortality risk, functional decline, falls, and disability. However, effective strategies that respond to the needs of socially frail older adults are lacking and few studies have unpacked how social determinants operate or how interventions can be adapted during periods requiring social distancing and isolation such as the COVID-19 pandemic. To address these gaps, we conducted a scoping review using JBI methodology to identify interventions that have the best potential to help socially frail older adults (age ≥65 years).
We searched MEDLINE, CINAHL (EPSCO), EMBASE and COVID-19 databases and the grey literature. Eligibility criteria were developed using the PICOS framework. Our results were summarized descriptively according to study, patient, intervention and outcome characteristics. Data synthesis involved charting and categorizing identified interventions using a social frailty framework. RESULTS: Of 263 included studies, we identified 495 interventions involving ~124,498 older adults who were mostly female. The largest proportion of older adults (40.5%) had a mean age range of 70-79 years. The 495 interventions were spread across four social frailty domains: social resource (40%), self-management (32%), social behavioural activity (28%), and general resource (0.4%). Of these, 189 interventions were effective for improving loneliness, social and health and wellbeing outcomes across psychological self-management, self-management education, leisure activity, physical activity, Information Communication Technology and socially assistive robot interventions. Sixty-three interventions were identified as feasible to be adapted during infectious disease outbreaks (e.g., COVID-19, flu) to help socially frail older adults.
Our scoping review identified promising interventions with the best potential to help older adults living with social frailty.
社会脆弱性对老年人的影响是深远的，包括死亡率风险、功能下降、跌倒和残疾。然而，缺乏应对社会脆弱老年人需求的有效策略，很少有研究揭示社会决定因素如何运作，或者在需要社会隔离和隔离的时期（如 COVID-19 大流行期间）如何调整干预措施。为了解决这些差距，我们使用 JBI 方法学进行了范围综述，以确定最有潜力帮助社会脆弱老年人（年龄≥65 岁）的干预措施。
我们搜索了 MEDLINE、CINAHL（EPSCO）、EMBASE 和 COVID-19 数据库以及灰色文献。使用 PICOS 框架制定了入选标准。根据研究、患者、干预和结果特征，对我们的结果进行了描述性总结。数据综合涉及使用社会脆弱性框架对确定的干预措施进行图表绘制和分类。
在 263 项纳入的研究中，我们确定了 495 项涉及约 124498 名老年人的干预措施，其中大多数为女性。最大比例的老年人（40.5%）年龄在 70-79 岁之间。495 项干预措施分布在四个社会脆弱性领域：社会资源（40%）、自我管理（32%）、社会行为活动（28%）和一般资源（0.4%）。其中，189 项干预措施在改善孤独感、社会和健康福祉方面是有效的，涉及心理自我管理、自我管理教育、休闲活动、体育活动、信息通信技术和社交辅助机器人干预。确定了 63 项干预措施在传染病暴发期间（如 COVID-19、流感）具有适应性，以帮助社会脆弱的老年人。
我们的范围综述确定了最有潜力帮助患有社会脆弱性的老年人的有希望的干预措施。
