|Summary / Abstract |
Reducing social isolation is likely to have positive effects on health and mortality:
Greater benefits were observed (in reducing mortality) from improving levels of social
isolation, compared to reducing loneliness.
Targeting has the greatest impact: Focussing public health intervention efforts on
those most at risk, e.g those who live alone, are on low incomes, have poorer health,
been recently bereaved or are carers – rather than all older people – is more effective.
There is still considerable stigma attached to being lonely: and initiatives should
bear this in mind. For example, their marketing materials, should not use the ‘L’ word (as
Age UK call loneliness), particularly if they wish to attract more men
Initiatives based on evidence were more effective than those that were not: 87% of
interventions based on evidence reported beneficial effects compared to 59% of
interventions which were not. Studies aiming to achieve and maintain characteristics
essential for positive mental health (e.g people realising their own abilities, having a
purpose in life, a sense of belonging and support) appeared to be most effective.
Group activities achieve good outcomes: 79% of group based interventions reported
at least one improved outcome, compared to 55% of one-to-one interventions.
Group activities which have an arts, educational learning or social focus are
particularly beneficial: A systematic review supported this finding that group
interventions involving some form of educational, training, arts or social activity that
target specific groups of people are the most effective.
Participatory initiatives are most beneficial: Positive effects are reported in 80% of
initiatives which were participatory, compared to 44% of non-participatory initiatives.
One-to-one initiatives (e.g befriending) only appears to be effective in certain
circumstances: Namely, when the befriender and recipient have enough in common to
build a genuine relationship. They do not appear to reduce use of health services, but
can result in reductions in depression and improvements in quality of life. One-to-one
interventions targeted at specific groups of older people (e.g the recently bereaved, or
recently discharged from hospital), may offer more benefit than trying to reach to all
older people. Currently, there is little evidence of benefit for mentoring support.
The impact of new technologies is inconclusive: The evidence is often contradictory
on the subject of new technologies, but there is some evidence of benefit for training on
the use of computers, the internet, Skype (particularly for specific groups such as carers)
Real and practical barriers to reducing isolation should be the focus of joint
efforts by all agencies concerned with the wellbeing of older people: particularly
those relating to transport, toilets, continence issues and long term health conditions