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Journal ArticleDOI

Social isolation and loneliness among older people: issues and future challenges in community and residential settings.

01 Aug 2008-Australian Health Review (CSIRO Publishing)-Vol. 32, Iss: 3, pp 468-478
TL;DR: The need to conduct more residential care-focused research; the importance of addressing a variety of methodological concerns; and the need for practitioners to develop intervention programs that are appropriately targeted, evidence-based and evaluated are identified.
Abstract: Although often associated with older age, loneliness and social isolation are not well understood in terms of their prevalence, risk and protective factors. Evidence suggests that only a minority of community-dwelling older people are "severely" lonely or isolated, however a number of factors need to be considered to fully understand the extent and significance of the problem. Community-based studies have identified a variety of risk factors for loneliness/isolation including widowhood, no (surviving) children, living alone, deteriorating health, and life events (eg, loss and bereavement). Having a confidant has been identified as a protective factor for loneliness. However, evidence is often unclear or inconclusive, especially within residential settings. We identified the need to conduct more residential care-focused research; the importance of addressing a variety of methodological concerns; and the need for practitioners to develop intervention programs that are appropriately targeted, evidence-based and evaluated.

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Citations
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Journal ArticleDOI
TL;DR: Assessment of the effectiveness of interventions designed to alleviate social isolation and loneliness in older people found common characteristics of effective interventions were those developed within the context of a theoretical basis, and those offering social activity and/or support within a group format.
Abstract: Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL) were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87% reported beneficial effects across the three domains compared with 59% of interventions with no evident theoretical foundation. Regarding intervention type, 86% of those providing activities and 80% of those providing support resulted in improved participant outcomes, compared with 60% of home visiting and 25% of internet training interventions. Fifty eight percent of interventions that explicitly targeted socially isolated or lonely older people reported positive outcomes, compared with 80% of studies with no explicit targeting. More, well-conducted studies of the effectiveness of social interventions for alleviating social isolation are needed to improve the evidence base. However, it appeared that common characteristics of effective interventions were those developed within the context of a theoretical basis, and those offering social activity and/or support within a group format. Interventions in which older people are active participants also appeared more likely to be effective. Future interventions incorporating all of these characteristics may therefore be more successful in targeting social isolation in older people.

589 citations


Cites background from "Social isolation and loneliness amo..."

  • ...Many authors agree that it is a uni-dimensional concept referring to the lack of social integration [5-8]....

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  • ...Loneliness is a subjective concept resulting from a perceived absence or loss of companionship [6,13-15]....

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  • ...Expanding the distinction further, while social isolation may be either voluntary or involuntary, loneliness is always involuntary [6,19]....

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Journal ArticleDOI
TL;DR: There is no one-size-fits-all approach to addressing loneliness or social isolation, and hence the need to tailor interventions to suit the needs of individuals, specific groups or the degree of loneliness experienced.
Abstract: Loneliness and social isolation are growing public health concerns in our ageing society. Whilst these experiences occur across the life span, 50% of individuals aged over 60 are at risk of social isolation and one-third will experience some degree of loneliness later in life. The aim of this scoping review was to describe the range of interventions to reduce loneliness and social isolation among older adults that have been evaluated; in terms of intervention conceptualisation, categorisation, and components. Three electronic databases (CINAHL, Embase and Medline) were systematically searched for relevant published reviews of interventions for loneliness and social isolation. Inclusion criteria were: review of any type, published in English, a target population of older people and reported data on the categorisation of loneliness and/or social isolation interventions. Data extracted included: categories of interventions and the reasoning underpinning this categorisation. The methodology framework proposed by Arskey and O’Malley and further developed by Levac, et al. was used to guide the scoping review process. A total of 33 reviews met the inclusion criteria, evaluating a range of interventions targeted at older people residing in the community or institutionalised settings. Authors of reviews included in this paper often used the same terms to categorise different intervention components and many did not provide a clear definition of these terms. There were inconsistent meanings attributed to intervention characteristics. Overall, interventions were commonly categorised on the basis of: 1) group or one-to-one delivery mode, 2) the goal of the intervention, and 3) the intervention type. Several authors replicated the categorisation system used in previous reviews. Many interventions have been developed to combat loneliness and social isolation among older people. The individuality of the experience of loneliness and isolation may cause difficulty in the delivery of standardised interventions. There is no one-size-fits-all approach to addressing loneliness or social isolation, and hence the need to tailor interventions to suit the needs of individuals, specific groups or the degree of loneliness experienced. Therefore, future research should be aimed at discerning what intervention works for whom, in what particular context and how.

314 citations


Cites background or methods from "Social isolation and loneliness amo..."

  • ...Alternatively Grenade and Boldy [46] categorised interventions by their ‘nature’ and ‘goal’, and Cohen-Mansfield and Perach [53] categorised interventions based on their ‘focus’ and ‘type’....

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  • ...Grenade L, Boldy D. Social isolation and loneliness among older people: issues and future challenges in community and residential settings....

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  • ...In the third review [46], the authors implicitly addressed these three constructs but used different terminology, i....

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  • ...Three reviews categorised interventions by their ‘goal’ [42, 44, 46]....

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  • ...Alternatively Grenade and Boldy [46] categorised interventions by their ‘nature’ and...

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Journal ArticleDOI
TL;DR: This work conceptualize age-friendly communities by building on the WHO framework and applying an ecological perspective and aims to make explicit key assumptions of the interplay between the person and the environment to advance research or policy decisions in this area.
Abstract: On the political and policy front, interest has increased in making communities more "age-friendly", an ongoing trend since the World Health Organization launched its global Age-Friendly Cities project. We conceptualize age-friendly communities by building on the WHO framework and applying an ecological perspective. We thereby aim to make explicit key assumptions of the interplay between the person and the environment to advance research or policy decisions in this area. Ecological premises (e.g., there must be a fit between the older adult and environmental conditions) suggest the need for a holistic and interdisciplinary research approach. Such an approach is needed because age-friendly domains (the physical environment, housing, the social environment, opportunities for participation, informal and formal community supports and health services, transportation, communication, and information) cannot be treated in isolation from intrapersonal factors, such as age, gender, income, and functional status, and other levels of influence, including the policy environment.

272 citations


Additional excerpts

  • ...…2003 ; Putnam, 2000 ; Woolcock, 2001 ) and social networks (Berkman & Syme, 1979 ; Spencer & Pahl, 2006 ), as well as concepts of social isolation (Conor, Luanaigh, & Lawlor, 2008 ; Grenade & Boldy, 2008 ) and social exclusion (Scharf & Bartlam, 2006 , 2008 ; Scharf, Phillipson, & Smith, 2004 )....

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Journal ArticleDOI
Vera Toepoel1
TL;DR: It is shown that leisure activities explain a significant part of older people’s social connectedness, and local communities can use these close relationships and develop special programs to increase socialconnectedness and hence improve quality of life for older adults.
Abstract: This study investigates the relation between leisure activities and the social status of the elderly based on a heterogeneous sample of the Dutch population. Close relationships are also analyzed to identify which people could serve as successful stimulators of leisure participation. The social profile confirms that older people have fewer social contacts and often feel lonely. This study shows that leisure activities explain a significant part of older people’s social connectedness. Voluntary work, cultural activities, holiday, sports, reading books, hobbies and shopping are found to be successful predictors for social connectedness of older people. Watching TV, listening to the radio, and spending time behind the computer (passive activities) were not associated with social connectedness. Friends correlate positively to participation in leisure activities. Partners play a role in participation in cultural activities and sports; parents play a role in participation in voluntary work and holidays; siblings play a role in voluntary work and sports; and children play a role in cultural activities, reading books, and shopping. Local communities can use these close relationships and develop special programs to increase social connectedness and hence improve quality of life for older adults.

268 citations


Cites background from "Social isolation and loneliness amo..."

  • ...1985), having a confidant (Grenade and Boldy 2008), and family (Fiori et al....

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  • ...Interaction with strong ties (Lin et al. 1985), having a confidant (Grenade and Boldy 2008), and family (Fiori et al. 2006) were found to be most beneficial....

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  • ...As suggested by Grenade and Boldy (2008), there is a need for strategic thinking in order to provide older people with maximum opportunities to maintain a good quality of life....

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References
More filters
Journal ArticleDOI
TL;DR: The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts.
Abstract: The relationship between social and community ties and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California and a subsequent nine-year mortality follow-up. The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts. The age-adjusted relative risks for those most isolated when compared to those with the most social contacts were 2.3 for men and 2.8 for women. The association between social ties and mortality was found to be independent of self-reported physical health status at the time of the 1965 survey, year of death, socioeconomic status, and health practices such as smoking, alcoholic beverage consumption, obesity, physical activity, and utilization of preventive health services as well as a cumulative index of health practices.

4,882 citations

Journal ArticleDOI
TL;DR: The psychometric properties of the UCLA Loneliness Scale (Version 3) were evaluated and it was indicated that the measure was highly reliable, both in terms of internal consistency and test-retest reliability over a 1-year period.
Abstract: In this article I evaluated the psychometric properties of the UCLA Loneliness Scale (Version 3). Using data from prior studies of college students, nurses, teachers, and the elderly, analyses of the reliability, validity, and factor structure of this new version of the UCLA Loneliness Scale were conducted. Results indicated that the measure was highly reliable, both in terms of internal consistency (coefficient alpha ranging from .89 to .94) and test-retest reliability over a 1-year period (r = .73). Convergent validity for the scale was indicated by significant correlations with other measures of loneliness. Construct validity was supported by significant relations with measures of the adequacy of the individual's interpersonal relationships, and by correlations between loneliness and measures of health and well-being. Confirmatory factor analyses indicated that a model incorporating a global bipolar loneliness factor along with two method factors reflecting direction of item wording provided a very goo...

3,661 citations

Book
01 Jan 1974
TL;DR: Loneliness: The Experience of Emotional and Social Isolation brings together papers which attempt to capture the phenomena of loneliness with case materials that illuminate the descriptive and theoretical acccounts as discussed by the authors.
Abstract: Loneliness is among the most common distresses. In one survey, a quarter of Americans interviewed said that they had suffered from loneliness within the past few weeks. Yet for a condition so pervasive, loneliness has received little professional attention.Loneliness: The Experience of Emotional and Social Isolation brings together papers which attempt to capture the phenomena of loneliness with case materials that illuminate the descriptive and theoretical acccounts. It is organized into seven sections, covering: explanations for the neglect of loneliness, and an attept to describe the condition; mechanisms underlying some forms of loneliness; a discussion of situations in which loneliness is commonly found; loneliness among those suffering the loss of a loved one; the loneliness of social isolation; resources available to the lonely; and, finally, a look at issues yet to be dealt with and some suggestions for the management of loneliness. This book is a useful resource for social scientists, clinicians, and individuals who now or in the future may suffer from loneliness.

1,595 citations

Journal ArticleDOI
TL;DR: In this article, a wide range of in-depth research into loneliness and its treatment is presented, such as the difference between loneliness and being alone, the various types of loneliness, why people become lonely, and how the lonely can be helped.
Abstract: This compendium offers a wide range of in-depth research into loneliness and its treatment. Sociologists and psychologists address issues such as the difference between loneliness and being alone, the various types of loneliness, why people become lonely, and how the lonely can be helped. A selected bibliography on loneliness is also included.

1,545 citations