Long-Term Effects on Loneliness of a Computer-Tailored Intervention for Older Adults With Chronic Diseases: A Randomized Controlled Trial

Abstract

Objectives: This study explores the effects of the Active Plus intervention aiming to decrease loneliness among older adults (>65 years) with chronic diseases. Methods: A randomized controlled trial (RCT) was performed (N = 585; age: M = 74.5 years, SD = 6.4), assessing loneliness at baseline, 6 months and 12 months. Outcome measures in the multilevel linear regression analyses were total, social and emotional loneliness. Results: At 12 months, significant decreases in total ( B = −.37, p = .01) and social loneliness ( B = −.24, p = .02) were found. Age was a significant moderator for total and social loneliness; however, the intervention was effective only for participants aged 80 years and older. Discussion: The Active Plus intervention showed a significant decrease in total and social loneliness and was especially beneficial for the vulnerable age group of 80 years and older. A more comprehensive tool for measuring social activity and mobility impairments, and using a longer time frame to detect loneliness changes, may form interesting future research.

Protocol for the Development and Evaluation of Elderly Active & Connected: An Integral Neighbourhood-oriented Approach to Support Healthy Ageing in Low Socioeconomic Older Adults

“…The intervention expands and complements the existing Active Plus (and Active Plus65) physical activity intervention. While Active Plus effectively improved physical activity and reduced loneliness (27,29,53), the original intervention did not su ciently address the speci c needs of older adults in a low SEP (54). This was due to the fact that Active Plus primarily (and solely) focused on improving physical activity and, therefore, did not employ an integral or holistic approach, whereas the latter seems to resonate well with individuals in a low SEP (21).…”

“…First, Active Plus improved short-and long-term physical activity in adults aged 50 years and over (27,53). Additionally, a recent study reported by Boekhout et al demonstrated that Active Plus (or Active Plus65; mainly designed for older adults) signi cantly reduced overall loneliness, based on the effects of social loneliness, amongst single, independently living older adults with chronic diseases (29). However, Active Plus by itself remained insu cient to improve physical activity in vulnerable older adults aged 65 years or older (54).…”

“…This objective ties in seamlessly with the primary purpose of Active Plus, which is to stimulate physical activity initiation and maintenance among individuals over the age of 50 (27,28). At the same time, Active Plus is also well capable of reducing loneliness (29).…”

Effective interventions to reduce loneliness in big cities

“…Web-based interventions are a second option and can be used to deliver different content to individuals. It is possible to implement group interventions via videoconferencing apps (e.g., Zoom) in which therapeutic techniques and skills are being taught [35 ▪▪ ] or to address cognitive functioning and increase physical activity while also providing computer-tailored advice to reduce loneliness (the Active Plus program) [36 ▪▪ ]. Both programs deliver evidence-based therapeutic techniques that previously have shown to reduce loneliness [37].…”

Association between changes in loneliness identified through screening and changes in depression or anxiety in older adults

“…Because of the high prevalence of loneliness, its effects on health, and increasing evidence that interventions may reduce loneliness, 10,15–18 clinical screening for loneliness among older adults may be warranted 2 . For older adults who receive health insurance through the Medicare Advantage program, annual wellness visits, required by the Centers for Medicare and Medicaid Services (CMS) since 2011, provide an opportunity to screen for loneliness and other health concerns 19 .…”