Conn David K, Billard Tanya, Dupuis-Blanchard Suzanne, Freedman Amy K, Hoang Peter M, Levasseur Mélanie, Newall Nancy E, Sullivan Mary Pat, Wister Andrew V
Baycrest Health Sciences, North York, ON.
Department of Psychiatry, University of Toronto, Toronto, ON.
Can Geriatr J. 2024 Dec 1;27(4):531-538. doi: 10.5770/cgj.27.772. eCollection 2024 Dec.
Preventing and addressing social isolation and loneliness among older adults is important because of the known associations with negative health outcomes. The Canadian Coalition for Seniors' Mental Health (CCSMH) took on the task of creating clinical guidelines.
A multidisciplinary working group was established. The process was guided by an initial rapid scoping review of the literature focused on older adults. An adapted GRADE approach was utilized.
CCSMH has produced first-ever clinical guidelines on social isolation and loneliness in older adults. Prevention, including recognition of risk factors and educational approaches focused on clinicians and students, is recommended. Targeted screening with validated tools is recommended. A comprehensive assessment is optimal to treat any underlying conditions and to identify contributing factors that may be responsive to psychosocial interventions. An individualized approach to interventions with shared decision-making is recommended. A variety of possible interventions include social prescribing, social activity, physical activity, psychological therapies, animal-assisted therapies and ownership, leisure skill development and activities, and the use of technology.
The problem of social isolation and loneliness is a "geriatric" giant that needs to be recognized and addressed. Because of its complexity, it will require the collective attention of many individuals and organizations working together at multiple levels of society, to raise awareness and find solutions. We recommend that health-care and social service providers use these guidelines as a comprehensive tool to identify, assess, and implement strategies to reduce the negative impact of social isolation and loneliness.
鉴于已知社交隔离和孤独感与负面健康结果相关，预防和解决老年人的社交隔离和孤独感至关重要。加拿大老年人心理健康联盟（CCSMH）承担了制定临床指南的任务。
成立了一个多学科工作组。该过程以对关注老年人的文献进行初步快速范围审查为指导。采用了一种改编的GRADE方法。
CCSMH制定了有史以来第一份关于老年人社交隔离和孤独感的临床指南。建议进行预防，包括识别风险因素以及针对临床医生和学生的教育方法。建议使用经过验证的工具进行针对性筛查。进行全面评估以治疗任何潜在疾病并识别可能对心理社会干预有反应的促成因素。建议采用个性化的干预方法并进行共同决策。各种可能的干预措施包括社会处方、社交活动、体育活动、心理治疗、动物辅助治疗与陪伴、休闲技能发展与活动以及技术的使用。
社交隔离和孤独感问题是一个需要被认识和解决的“老年”难题。由于其复杂性，这将需要许多个人和组织在社会的多个层面共同关注，以提高认识并找到解决方案。我们建议医疗保健和社会服务提供者将这些指南用作识别、评估和实施策略的综合工具，以减少社交隔离和孤独感的负面影响。
