Abstract
BackgroundSocial connection is recognized as an important determinant of health and well-being. The negative health impacts of poor social connection have been reported in research in older adults, however, less is known about the health impacts for those living in long-term care (LTC) homes. This review seeks to identify and summarize existing research to address the question: what is known from the literature about the association between social connection and physical health outcomes for people living in LTC homes?MethodsA scoping review guided by the Arksey & O’Malley framework was conducted. Articles were included if they examined the association between social connection and a physical health outcome in a population of LTC residents.ResultsThirty-four studies were included in this review. The most commonly studied aspects of social connection were social engagement (n = 14; 41%) and social support (n = 10; 29%). A range of physical health outcomes were assessed, including mortality, self-rated health, sleep, fatigue, nutrition, hydration, stress, frailty and others. Findings generally support the positive impact of social connection for physical health among LTC residents. However, most of the studies were cross-sectional (n = 21; 62%) and, of the eleven cohort studies, most (n = 8; 73%) assessed mortality as the outcome. 47% (n = 16) were published from 2015 onwards.ConclusionsResearch has reported positive associations between social connection and a range of physical health outcomes among LTC residents. These findings suggest an important role for social connection in promoting physical health. However, further research is needed to consider the influence of different aspects of social connection over time and in different populations within LTC homes as well as the mechanisms underlying the relationship with health.
Highlights
Social connection is recognized as an important determinant of health and well-being
There are no published reviews on the association between social connection and physical health among long-term care (LTC) home residents. The objective of this scoping review is to identify and summarize the existing research to address the question: what is known from the literature about the association between social connection and physical health outcomes for people living in LTC homes? We chose scoping review methodology to answer a broad research question by assessing published literature in which we anticipated a heterogeneous list of exposures and health outcomes, to identify and report knowledge gaps [21,22,23]
The list was distilled to 585 papers that quantified social connection in LTC residents, from which 34 papers were identified for the current analysis
Summary
Social connection is recognized as an important determinant of health and well-being. This review seeks to identify and summarize existing research to address the question: what is known from the literature about the association between social connection and physical health outcomes for people living in LTC homes?. A 2015 metaanalysis found that low social integration and low social support, two aspects of social connection, had a greater impact on mortality than smoking, body mass index (BMI), physical activity, and alcohol consumption [3]. The mechanisms underlying these associations have been postulated to include immune system function [6], stress regulation [7], and health behaviours (e.g., diet and exercise) [8]. Amid the current COVID-19 pandemic, LTC homes have restricted visitors (including family and friends) and group activities [18, 19] as a means of infection-control, which has had devastating impacts on social connection for residents [18, 20]
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