Interventions for social isolation in older adults who have experienced a fall: a systematic review

Abstract

ObjectivesThe objective of our systematic review was to identify the effective interventions to prevent or mitigate social isolation and/or loneliness in older adults who experienced a fall.DesignSystematic review.Data sourcesMEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Ageline were searched (from inception to February 2020).MethodsStudies were eligible if they described any intervention for social isolation in older adults living in a community setting who experienced a fall, and reported outcomes related to social isolation or loneliness.Two independent reviewers screened citations, abstracted data and appraised risk of bias using the Cochrane risk of bias tool. The results were summarised descriptively.ResultsAfter screening 4069 citations and 55 full-text articles, four studies were included. The four studies varied in study design, including a randomised controlled trial, non-randomised controlled trial, an uncontrolled before-after study and a quasiexperimental study. Interventions varied widely, and included singing in a choir, a patient-centred, interprofessional primary care team-based approach, a multifactorial assessment targeting fall risk, appropriate medication use, loneliness and frailty, and a community-based care model that included comprehensive assessments and multilevel care coordination. Outcome measures varied and included scales for loneliness, social isolation, social interaction, social networks and social satisfaction. Mixed results were found, with three studies reporting no differences in social isolation or loneliness after the intervention. Only the multifactorial assessment intervention demonstrated a small positive effect on loneliness compared with the control group after adjustment (B=−0.18, 95% CI −0.35 to −0.02).ConclusionsFew studies examined the interventions for social isolation or loneliness in older adults who experienced a fall. More research is warranted in this area.PROSPERO registration numberCRD42020198487.

Effectiveness of interventions to address different types of vulnerabilities in community‐dwelling older adults: An umbrella review

“…Fourteen reviews (54%, 14/26) included physical activity interventions and technologies such as telemonitoring/tele‐care were used to address frailty, social isolation, and loneliness (Anton et al, 2018 ; Arantes et al, 2009 ; Burton et al, 2019 ; Dedeyne et al, 2017 ; Frost et al, 2017 ; Heins et al, 2021 ; Kelaiditi et al, 2014 ; Khosravi et al, 2016 ; Li et al, 2022 ; Pool et al, 2017 ; Puts et al, 2017 ; Shvedko et al, 2018 ; Snowden et al, 2014 ; Theou et al, 2011 ; Wister et al, 2021 ). Ten reviews included (38%) Interventions combining diet and physical activity, interventions combining diet, physical activity and nutritional advise, and preventive integrated care interventions were deployed to address frailty and social isolation (Anton et al, 2018 ; Dedeyne et al, 2017 ; Frost et al, 2017 ; Ibrahim et al, 2022 ; Kelaiditi et al, 2014 ; Liao et al, 2018 ; Looman et al, 2019 ; Puts et al, 2017 ; Theou et al, 2011 ; Tricco et al, 2022 ) (Tables 1 , 2 , 3 ).…”

“…There was great variety in the measurement tools used to assess social isolation and its related dimensions. Instruments included: Lubben Social Network Scale (LSNS) (Franck et al, 2016 ; Heins et al, 2021 ), two questions on social isolation developed by authors (Franck et al, 2016 ), Internally developed social support scale (Hagan et al, 2014 ), Medical Outcomes Study (MOS) Social Support Survey (Hagan et al, 2014 ; Heins et al, 2021 ; Shvedko et al, 2018 ), social provisions scale (Hagan et al, 2014 ; Heins et al, 2021 ), The Multidimensional Scale of Perceived Social Support (Pool et al, 2017 ; Shvedko et al, 2018 ; Heins et al, 2021 ), Duke Social Support Index (Heins et al, 2021 ; Sims‐Gould et al, 2017 ; Tricco et al, 2022 ; Wister et al, 2021 ), the Patient Reported Outcome Measurement Information System (PROMIS)—Social Isolation (six‐item) (Wister et al, 2021 ), Social activities from the RAND Social Health Battery (one item on social participation) (Cohen‐Mansfield & Perach, 2015 ), Items from the Older American Resources and Services (OARS) social resource rating scale (custom item on satisfaction with socialization) (Cohen‐Mansfield & Perach, 2015 ), Items tapping daily activities and social contact (Cohen‐Mansfield & Perach, 2015 ), and Social Provisions Scale (Heins et al, 2021 ), Multidimensional Scale of Perceived Social Support (MSPSS) (Shvedko et al, 2018 ; Heins et al, 2021 ), Self‐report of social Interaction and social network (Cohen‐Mansfield & Perach, 2015 ; Heins et al, 2021 ).…”

Global evidence on falls and subsequent social isolation in older adults: a scoping review

“…As mentioned in our related systematic review on interventions for social isolation after falling, social isolation and loneliness are distinct concepts. 12 Social isolation included a decrease in any of the following: number of social contacts, feeling of belonging, fulfilling relationships, engagement with others and quality of their personal network. 12 We defined loneliness as ‘the unpleasant experience that occurs when a person’s network of social relations is deficient in some way, either quantitatively or qualitatively’.…”

“… 12 Social isolation included a decrease in any of the following: number of social contacts, feeling of belonging, fulfilling relationships, engagement with others and quality of their personal network. 12 We defined loneliness as ‘the unpleasant experience that occurs when a person’s network of social relations is deficient in some way, either quantitatively or qualitatively’. 13 For our primary objective, the context included any community or institutional setting.…”

“…The concept was the relationship between falls and subsequent social isolation or loneliness. As mentioned in our related systematic review on interventions for social isolation after falling, social isolation and loneliness are distinct concepts 12. Social isolation included a decrease in any of the following: number of social contacts, feeling of belonging, fulfilling relationships, engagement with others and quality of their personal network 12.…”