Systematic Review of Loneliness and Social Isolation Interventions in Obesity and Obesity-Related Complications.

BackgroundSocial isolation and loneliness are urgent public health concerns associated with negative physical and mental health outcomes. Understanding effective remedies is crucial in addressing these problems. This umbrella review aimed to synthesize and critically appraise scientific evidence on the effectiveness of social isolation and loneliness interventions overall and across subgroups. We focused on systematic reviews (SRs) of randomized controlled trials (RCTs).MethodsWe searched seven databases (June 2022 and updated June 2023) and supplemented the search with grey literature and reference screening to identify SRs published since 2017. Screening, data extraction, and quality assessment using the AMSTAR2 tool were conducted independently by author pairs, with disagreements resolved through discussion.ResultsWe included 29 SRs, 16 with meta-analysis and 13 with narrative synthesis. All SRs focused on loneliness, with 12 additionally examining social isolation. Four SRs focused on young people, 11 on all ages, and 14 on older adults. The most frequently examined intervention types were social (social contact, social support), psychological (therapy, psychoeducation, social skills training), and digital (e.g., computer use and online support). Meta-analyses indicated small-to-moderate beneficial effects, while narrative synthesis demonstrated mixed or no effect. Social interventions for social isolation and psychological interventions for loneliness were the most promising. However, caution is warranted due to the effects’ small magnitude, significant heterogeneity, and the variable quality of SRs. Digital and other interventions showed mixed or no effect; however, caution is advised in interpreting these results due to the highly diverse nature of the interventions studied.ConclusionsThis overview of SRs shows small to moderate effectiveness of social interventions in reducing social isolation and psychological ones in tackling loneliness. Further rigorously conducted RCTs and SRs are needed to guide policy decisions regarding the implementation of efficacious and scalable interventions. Evaluation should focus on both preventive structural interventions and tailored mitigating strategies that address specific types and causes of loneliness.

Social Disconnection in Late Life Mental Illness – Commentary From the National Institute of Mental Health

Causal Relationship Between Social Isolation, Loneliness, and Cardiovascular Disease

AimsObesity and depression are increasing in prevalence and have become key issues in the public health of the modern day. We performed a meta-review to summarise the association between obesity and depression in adults.MethodA systematic literature search was undertaken on MEDLINE, PsychINFO, EMBASE and Web of Science for systematic reviews (SRs) with or without meta-analyses (MA) on the association between obesity and depression in adults (>18 years) published before 18 September 2018. Any approach to define depressive disorders (e.g. via structured interview or code in medical file) was accepted. Likewise, any method to assess obesity was accepted. Screening, data extraction and quality assessment was completed by two reviewers independently, with a third reviewer to arbitrate any disagreement. AMSTAR 2 tool was used to assess the methodological quality and risk of bias of the pertinent SRs/MAs.ResultAfter duplicate removal, we identified 6007 potentially pertinent citations. Following, title, abstract and full-text screening, 10 studies were included in the review; nine SRs with MAs and one SR. A statistically significant association between obesity and depression was reported in all nine SRs with MAs, with odds ratios ranging from 1.18 (95% CI = 1.11-1.26) to 1.57 (95% CI = 1.53-2.01). Increased severity of obesity (body mass index over 40) was associated with a greater odds of becoming depressed. Odds of developing depression were greater for obese females, compared to obese males, but this difference was not statistically significant. Depression was shown to be a significant risk factor for future obesity in all four relevant MAs with odds ratios ranging from 1.18 (95% CI = 1.13-1.23) to 1.40 (95% CI = 1.14-1.71) . Depressed adolescent females had the highest odds of becoming obese, significantly more so than depressed adolescent males and depressed adults. The quality of the included studies were mixed with five scoring moderate quality, three low quality and two critically low quality.ConclusionThe findings suggest a reciprocal association between depression and obesity, which may be modulated by age and gender. Future research should assess the potential effect of obesity and depression severity more carefully while also exploring the underlying mechanisms. These results warrant the investigation of the effect of obesity or depression intervention on the outcomes of the other.FUNDINGThis research received no financial sponsorship.

Loneliness in the time of COVID-19: Impact on older adults.

Parkinson disease (PD) is a complex, noncurable, and progressive neurological disease affecting different areas of the human nervous system. PD is associated with both motor and nonmotor symptoms, which negatively affect patients' quality of life and may cause changes in socialization such as intentional social withdrawal. This may further lead to social isolation and loneliness. The use of information and communication technology (ICT) plays an important role in managing social isolation and loneliness. Currently, there is a lack of research focusing on designing and developing ICT solutions that specifically address social isolation and loneliness among people living with PD. This study addresses this gap by investigating barriers and social needs in the context of social isolation, loneliness, and technology use among people living with PD. The insights gained can inform the development of effective ICT solutions, which can address social isolation and loneliness and improve the quality of life for people living with PD. A qualitative study with 2 phases of data collection were conducted. During the first phase, 9 health care professionals and 16 people living with PD were interviewed to understand how PD affects social life and technology use. During the second phase, 2 focus groups were conducted with 4 people living with PD in each group to gather insights into their needs and identify ways to manage social isolation and loneliness. Thematic analysis was used to analyze both data sets and identify key themes. The results showed that the barriers experienced by people living with PD due to PD such as "fatigue," "psychological conditions," "social stigma," and "medication side effects" affect their social life. People living with PD also experience difficulties using a keyboard and mouse, remembering passwords, and navigating complex applications due to their PD-related physical and cognitive limitations. To manage their social isolation and loneliness, people living with PD suggested having a simple and easy-to-use solution, allowing them to participate in a digital community based on their interests, communicate with others, and receive recommendations for social events. The new ICT solutions focusing on social isolation and loneliness among people living with PD should consider the barriers restricting user's social activities and technology use. Given the wide range of needs and barriers experienced by people living with PD, it is more suitable to adopt user-centered design approaches that emphasize the active participation of end users in the design process. Importantly, any ICT solution designed for people living with PD should not encourage internet addiction, which will further contribute to the person's withdrawal from society.

Examining the Combined Effects of Social Isolation and Loneliness on Memory: A Systematic Review

Social isolation and loneliness are critical issues that shape the well-being of older adults and their family caregivers. Despite growing scientific inquiries into isolation and loneliness since the COVID-19 pandemic, these psychosocial challenges remain underexplored in family caregiving research. This symposium draws on multiple nationally representative datasets to examine how social connection, or lack thereof, influences caregiver experiences and mental health. Together, these papers explore the intersections of social engagement, isolation, and stress among diverse caregiving populations. First, Dr. Rosenberg presents data from the National Study of Caregiving (NSOC) to demonstrate the associations between caregiver participation in social activities and burden. Next, we examine the isolation and mental health of two subgroups of family caregivers for older adults. Dr. Pomeroy focuses on dementia caregivers, a subgroup of caregivers who bear high intensity and burden of care, to characterize how their social isolation and loneliness experiences differ by gender. Linking NSOC with the National Health and Aging Trends Study, Dr. Elmore focuses on understudied long-distance caregivers and examines the association between proximity and mental health. Lastly, Dr. Li presents a comparative analysis between caregivers and non-caregivers in the National Poll on Healthy Aging, demonstrating that despite the high prevalence of loneliness during the COVID-19 pandemic, caregivers are still less likely to use mental health self-care services. Overall, these papers explore caregivers’ distinct social experiences and offer potential targets to improve caregiver well-being. As the discussant, Dr. Kotwal will synthesize these presentations and propose targets for research, policy, and practice.

Association between willingness to participate in physical and social activities and loneliness in older adults: A stratified analysis by social isolation status

BackgroundSocial isolation and loneliness have emerged as important modifiable risk factors for mental disorders, posing significant public health challenges. However, they have not been comprehensively investigated in relation to multisystemic diseases and their temporal trajectories. We aimed to systematically identify the health outcomes associated with social isolation and loneliness and characterize their disease trajectories and comorbidity networks.MethodsA total of 466,547 participants (mean age: 56.5 ± 8.1, 54.6% females) with available information on social isolation and loneliness were included from the UK Biobank between 2006 and 2010 and followed up until 2022. Social isolation was measured using a composite score derived from three questions on number in household, frequency of friend and family visits, as well as participating in leisure and social activities. Loneliness was assessed by the subjective perception of feeling lonely and the willingness to confide in others. A total of 246 medical conditions were included in phenome-wide association analyses. Disease trajectory and comorbidity network analyses were performed to identify sequential patterns and visualize disease clusters.ResultsDuring an average medium follow-up of 11.7 years, social isolation was found to be significantly associated with increased risks of 28 medical conditions, and loneliness with 80. The strongest association for both exposures was with personality disorders, with respective hazard ratios of 2.12 (95% CI, 1.59–2.82) for social isolation and 2.62 (95% CI, 1.90–3.61) for loneliness. The conditions covered a broad spectrum, including respiratory, neurological, digestive, musculoskeletal, and genitourinary diseases and mental disorders. Three main disease clusters were identified in relation to social isolation and eight disease clusters were related to loneliness. Septicemia and alcohol-related disorders as the initial condition was notably observed in the disease cluster trajectories of both social isolation and loneliness. Subsequently, the comorbidity network revealed three and five distinct comorbidity modules associated with social isolation and loneliness, respectively. The disease nodes within these modules exhibited structural consistency with those within the disease trajectory clusters.ConclusionsThese findings highlight the importance of integrating screening, interventions, and referrals for social isolation and loneliness into health care system to prevent the adverse health conditions.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12916-025-04555-4.

Simple SummaryThe COVID-19 pandemic may have accelerated social isolation, particularly of older adults who are at increased risk of severe illness, while practicing physical distancing and self-quarantine. This study conducted in a metropolitan area of Japan hopes to provide stronger cross-cultural evidence of the positive impact of pet ownership on the psychological health of socially isolated owners with its large sample of older adults comparing two types of pet ownership (i.e., dog or cat). In this study, experience of dog or cat ownership and the presence or absence of social isolation were categorized into four groups to compare psychological health of each group. After adjusting for demographic and potential confounders, we found that socially isolated older adults who never owned a dog were more likely to report lower psychological health in comparison to socially isolated current or past dog owners. Our findings have practical implications that pets, particularly dogs, can play a role in increasing opportunities for engaging in physical and social activities and providing emotional support and thereby reducing a sense of social isolation and loneliness and improving psychological health among older adults.The psychological health effects of pet ownership have been widely studied, but only a few studies investigated its impact among socially isolated older adults. The present study aims to investigate the psychological health of older adults with or without the experience of pet (i.e., dog or cat) ownership who are socially isolated or not socially isolated. This study used cross-sectional data from 9856 community-dwelling older adults in a metropolitan area of Japan. Social and non-social isolation and type of pet ownership (i.e., dog or cat) were stratified to examine the psychological health. Logistic regression models indicated that, after adjusting for demographic and potential confounders, socially isolated older adults who never owned a dog were 1.22 times more likely to report lower psychological health in comparison to socially isolated current or past dog owners. No such difference was observed among cat owners. The results suggest that the experience of dog ownership may be effective to improve the psychological health among socially isolated older adult.

Emotional and social loneliness and their unique links with social isolation, depression and anxiety

Data on the association between social isolation, loneliness, and risk of incident coronary heart disease (CVD) are conflicting. The objective of this study is to determine the relationship between social isolation and loneliness, and the risk of developing cardiovascular disease (CVD) in middle age and elderly using meta-analysis. The purpose of the bibliometric analysis is to systematically evaluate the existing literature on the relationship between social isolation, loneliness, and the risk of developing cardiovascular disease (CVD) in middle-aged and elderly individuals. A comprehensive search through four electronic databases (MEDLINE, Google Scholar, Scopus, and Web of Science) was conducted for published articles that determined the association between social isolation and/or loneliness and the risk of developing coronary heart disease from June 2015 to May 2023. Two independent reviewers reviewed the titles and abstracts of the records. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline to conduct the systematic review and meta-analysis. Data for the bibliometric analysis was obtained from the Scopus database and analyzed using VOSviewer and Bibliometrix applications. Six studies involving 104,511 patients were included in the final qualitative review and meta-analysis after screening the records. The prevalence of loneliness ranged from 5 to 65.3%, and social isolation ranged from 2 to 56.5%. A total of 5073 cardiovascular events were recorded after follow-up, ranging between 4 and 13 years. Poor social relationships were associated with a 16% increase in the risk of incident CVD (Hazard Ratio of new CVD when comparing high versus low loneliness or social isolation was 1.16 (95% Confidence Interval (CI) 1.10–1.22). The bibliometric analysis shows a rapidly growing field (9.77% annual growth) with common collaboration (6.37 co-authors/document, 26.53% international). The US leads research output, followed by the UK and Australia. Top institutions include University College London, Inserm, and the University of Glasgow. Research focuses on "elderly," "cardiovascular disease," and "psychosocial stress," with recent trends in "mental health," "social determinants," and "COVID-19". Social isolation and loneliness increase the risk of and worsen outcomes in incident cardiovascular diseases. However, the observed effect estimate is small, and this may be attributable to residual confounding from incomplete measurement of potentially confounding or mediating factors. The results of the bibliometric analysis highlight the multidimensional nature of CVD research, covering factors such as social, psychological, and environmental determinants, as well as their interplay with various demographic and health-related variables.

BackgroundLiving alone may be associated with greater risk for social isolation and loneliness. Living alone, social isolation, loneliness, and limited engagement in social activity have all been associated with poorer cognitive function in later life. Hence, if individuals who live alone are also at greater risk of isolation and loneliness, this may exacerbate poor cognitive function. ObjectiveTo determine whether people living alone are more at risk of social isolation, feelings of loneliness, and limited social activity, and to examine the associations between living alone and cognitive function in later life. MethodBaseline (N = 2197) and two-year follow-up (N = 1498) data from community-dwelling participants, age ≥65 years, without cognitive impairment or depression at baseline from CFAS-Wales were used. Linear regression analyses were conducted to assess the association between living arrangement and cognitive function at baseline and two-year follow-up. ResultsPeople living alone were more isolated from family and experienced more emotional loneliness than those living with others, but were not more isolated from friends, did not experience more social loneliness, and were more likely to engage in regular social activity. Living alone was not associated with poorer cognitive function at baseline or two-year follow-up. DiscussionThese findings have positive implications and suggest that people who live alone in later life are not at greater risk of poor cognitive function at baseline or two-year follow-up. Social isolation may be more associated with poor cognitive function.

Social isolation, loneliness, and the risk of incident acute kidney injury in middle-aged and older adults: A prospective cohort study