Systematic review and meta-analysis of mechanistic loneliness interventions for older adults.

IF 4.8 3区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

Annals of the New York Academy of Sciences Pub Date : 2025-09-10 DOI:10.1111/nyas.70046

Andrea M Coppola,Stephanie Ibrahim,Nikki Bloch,Eric Sah,Shivani Mehta,Sanchit Goel,Jaclyn Calkins,Veronica Hernandez,Ellen E Lee

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Abstract

The current study aimed to evaluate specific mechanisms of interventions to improve loneliness among older adults. EMBASE, MEDLINE, and PsycINFO databases were searched for articles published through June 2024. We selected randomized controlled trials (RCTs) that sought to improve loneliness in older adults, were published in English, and used previously published measures to assess loneliness. We used random-effect models to calculate pooled standardized mean differences (SMDs) for each mechanistic approach, and random-effects meta-regression to assess heterogeneity of studies. Thirty-five RCTs from 31 published studies (total N = 5291 participants) met review criteria, including six distress tolerance interventions, 11 cognitive engagement and restructuring interventions, 12 social behavioral activation interventions, and six acceptance of aging interventions. Study samples included older adults from the community. Meta-analysis revealed significant pooled SMDs for improving loneliness (pooled SMD = -1.11 (95% CI [-2.19, -0.03], p = 0.043), 25 studies). Heterogeneity of studies was high (I2 = 99.57%). There was a trend for publication bias among cognitive and social behavioral activation interventions, though effect sizes did not change with adjustment. Meta-regression analysis found that distress tolerance interventions, group interventions, interventions with longer and more frequent sessions, and cognitive or acceptance of aging-focused interventions in older adults had larger effect sizes.

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老年人孤独感机械干预的系统回顾与荟萃分析。

本研究旨在评估改善老年人孤独感的具体干预机制。在EMBASE、MEDLINE和PsycINFO数据库中检索了截至2024年6月发表的文章。我们选择了旨在改善老年人孤独感的随机对照试验（rct），这些试验以英文发表，并使用先前发表的测量方法来评估孤独感。我们使用随机效应模型来计算每种机制方法的标准化平均差异（SMDs），并使用随机效应元回归来评估研究的异质性。来自31项已发表研究的35项随机对照试验（总N = 5291名参与者）符合审查标准，包括6项痛苦耐受干预、11项认知参与和重组干预、12项社会行为激活干预和6项接受衰老干预。研究样本包括来自社区的老年人。荟萃分析显示，综合SMD显著改善了孤独感（综合SMD = -1.11 (95% CI [-2.19, -0.03], p = 0.043)， 25项研究）。研究异质性高（I2 = 99.57%）。在认知和社会行为激活干预中存在发表偏倚的趋势，尽管效应量不随调整而改变。元回归分析发现，痛苦容忍干预、群体干预、更长时间和更频繁的干预以及老年人认知或接受以老龄化为重点的干预具有更大的效应量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of the New York Academy of Sciences 综合性期刊-综合性期刊

CiteScore

11.00

自引率

1.90%

发文量

193

审稿时长

2-4 weeks

期刊介绍： Published on behalf of the New York Academy of Sciences, Annals of the New York Academy of Sciences provides multidisciplinary perspectives on research of current scientific interest with far-reaching implications for the wider scientific community and society at large. Each special issue assembles the best thinking of key contributors to a field of investigation at a time when emerging developments offer the promise of new insight. Individually themed, Annals special issues stimulate new ways to think about science by providing a neutral forum for discourse—within and across many institutions and fields.