Abstract
Objective: To systematically analyze the effectiveness of technology-based interventions for reducing loneliness in older adults.Methods: We searched relevant electronic databases from inception to April 2021, which included Cochrane Library, PubMed, Web of Science, SpringerLink, EMBASE, CNKI, and Wanfang. The following criteria were used: (i) study design—randomized controlled trial (RCT) designs, (ii) people—older adults (aged ≥ 60 years), (iii) intervention—technology-based interventions in which a core component involved the use of technology to reduce loneliness in older adults; and (iv) outcome—reduction of loneliness level in terms of rating scale scores. Two reviewers independently identified eligible studies, extracted data, and assessed the risk of bias in the included studies. A third reviewer resolved any conflicts. The Cochrane Collaboration's bias assessment tool was used to evaluate the risk of bias for the included studies, and Review Manager 5.4 software was used for the meta-analysis. A random effects model was adopted to measure estimates of loneliness reduction, and standard mean differences (SMD) with a 95% confidence interval (CI) were calculated for each intervention-control contrast, and the I2 statistic was applied to examine heterogeneity.Results: A total of 391 participants from six RCTs were included in the review. Of these, three studies were rated as low-quality, and the remaining three were rated as moderate-quality studies. The meta-analysis showed that the evidence regarding the effects on loneliness of technology-based interventions compared with control groups was uncertain, and suggested that technology-based interventions resulted in little to no difference in loneliness reduction compared to control groups (SMD = −0.08, 95% CI −0.33 to 0.17, p = 0.53). Two types of technology-based interventions were identified: smartphone-based video calls and computer-based training with Internet usage. The subgroup analysis found low-quality evidence to support the effectiveness of both intervention types (SMD = −0.01, 95% CI −0.25 to 0.24, p = 0.95, and SMD = −0.38, 95% CI −0.19, 0.64, p = 0.47, respectively).Conclusions: We found no current evidence to support that technology-based interventions were effective compared to different control conditions in reducing loneliness in older adults. This suggests that more research is needed to investigate the effects of technology-based interventions on loneliness in older adults.
Highlights
Loneliness is usually defined as a subjective negative feeling of a lack of meaningful or intimate social relationships (Gierveld, 1998; Valtorta and Hanratty, 2012)
The results of the meta-analysis showed that technology-based interventions had little or no effect on loneliness reduction in older adults (SMD = −0.08, 95% confidence interval (CI) −0.33, 0.17, p = 0.53)
The results of the subgroup analysis showed that the effectiveness of computerbased training and Internet usage and smartphone-based video conferencing on reducing loneliness in older adults were both very uncertain (SMD = −0.38, 95% CI −1.39 to 0.64, p = 0.47 and standard mean difference (SMD) = −0.01, 95% CI −0.25, 0.24, p = 0.95, respectively) when compared with various control groups
Summary
Loneliness is usually defined as a subjective negative feeling of a lack of meaningful or intimate social relationships (Gierveld, 1998; Valtorta and Hanratty, 2012). Loneliness among the older adult population could be a growing global concern. According to data from the United States and Europe, loneliness was widespread among older adults; ∼40% of older adults in these countries experienced some form of loneliness, and this figure could remain constant for the years (Savikko et al, 2005; Victor et al, 2005; Hind et al, 2014). Victor et al (2005), for example, examined the prevalence of loneliness among older people in Great Britain, using a self-rating scale. Loneliness is frequently reported by older adults living alone. According to data from China, ∼17% of older Chinese adults lived alone in 2011 (Wang and Zhang, 2015). Since the number of older adults living alone is large, the actual number of people experiencing loneliness in China is considerable as well
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