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76 to 100 of 969An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers.
Background: Chronic venous leg ulcers (CVLUs) are the most common type of lower extremity wound. Even when treated with evidenced-based care, 30-50% of CVLUs fail to heal. A specific gap exists about the association between psychosocial stressors, particularly loneliness, and biomarkers of inflammation and immunity. Loneliness is highly prevalent in persons with CVLUs, has damaging effects on health, and contributes to the development of multiple chronic conditions, promotes aberrant inflammation, and diminishes healing. However, the confluence of loneliness, inflammation and the wound healing trajectory has not been elucidated; specifically whether loneliness substantially mediates systemic inflammation and alters healing over time. This study seeks to address whether there is a specific biomarker profile associated with loneliness, CVLUs, and wound healing that is different from non-lo…
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Tang VFY, Jiang D, Kwok JYY, Ho HCY, Jian IY, Choi NG, Cruwys T, You JHS, Warner LM, Seewer N, Bai X, Käll A, Andersson G, Krieger T, Lloyd-Evans B, Chou KL (2026)randomised controlled trialMEDLINE-indexed journal, not yet read by usFrontiers in public health Study Protocol: Connecting older adults through multi-level programmes for alleviating loneliness in Hong Kong older adults (COMPASS-HOA).
Background: Loneliness is a widespread global issue among older adults that negatively impacts physical and mental health, cognitive functioning, quality of life, and longevity, while also burdening society with healthcare costs. Resulting from factors at individual, interpersonal, and community levels. Multi-level interventions targeting these levels show promise in addressing this complex issue.
Objective: This trial aims to develop, implement, and evaluate a multi-level intervention comprising individual-, interpersonal-, and community-level components to reduce loneliness and enhance well-being among older adults in Hong Kong.
Methods: This pragmatic, assessor-blinded, 4-arm cluster randomized controlled trial will evaluate a multi-level intervention among 1,344 community-dwelling lonely older adults living in poverty. Participants will be randomized equally to one of the four 6-mont…
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The effects of volunteering on loneliness among lonely older adults: the HEAL-HOA dual randomised controlled trial.
Background: Previous randomised controlled trials have largely relied on self-reported volunteer work to assess the effects of volunteering and have rarely provided structured volunteering activities during the intervention period. The present study aimed to investigate the effects of social volunteering work over 12 months on loneliness among older adults during the COVID-19 pandemic.
Methods: A dual randomised controlled trial was done in Hong Kong to investigate the long-term effects of telephone-delivered psychosocial interventions by older Chinese volunteers who were screened as lonely, for older adult recipients who had low income, lived alone, felt lonely, and were digitally excluded. Participants were included if they were aged 50-70 years; had provided consent to be trained and serve as a volunteer for at least 2 h per week for 6 months; had at least 3 years of secondary school …
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Effects of volunteering over six months on loneliness, social and mental health outcomes among older adults: The HEAL-HOA Dual Randomized Controlled Trial.
Objective: To determine the beneficial effects of volunteering as lay counselor via telephone on own loneliness, social network engagement, perceived social support, stress, anxiety, and depressive symptoms among Chinese older adults in Hong Kong during the COVID-19 pandemic. DESIGN, SETTING, INTERVENTION, AND PARTICIPANTS: "Helping Alleviate Loneliness in Hong Kong Older Adults" (HEAL-HOA), a dual randomized controlled trial, was implemented to test effects of telephone-based psychosocial interventions delivered by older-adult volunteers for low-income lonely older adults. To evaluate the effects of volunteering on loneliness, we randomized 375 individuals ages 50-70 into a volunteering condition versus an active control (psychoeducation with social gatherings). Following a 6-week training, participants in the volunteering condition, delivered tele-interventions to older intervention re…
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Layperson-Delivered Telephone-Based Behavioral Activation Among Low-Income Older Adults During the COVID-19 Pandemic: The HEAL-HOA Randomized Clinical Trial.
Importance: Older adults are particularly vulnerable to loneliness and its physical and psychosocial sequelae, but scalable interventions are lacking, especially during disasters such as pandemics.
Objective: To compare the effects of layperson-delivered, telephone-based behavioral activation and mindfulness interventions vs telephone-based befriending on loneliness among at-risk older adults.
Design, setting, and participants: This assessor-blinded, 3-arm randomized clinical trial screened Chinese older adults through household visits and community referrals from April 1, 2021, to April 30, 2023, in Hong Kong. Eligible participants (≥65 years of age) who were lonely, digitally excluded, living alone, and living below the poverty line and provided consent to participate were randomized into behavioral activation, mindfulness, and befriending groups. Assessments were conducted at baseline…
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Lindsay EK, Creswell JD, Stern HJ, Greco CM, Walko TD, Dutcher JM, Wright AGC, Brown KW, Marsland AL (2022)randomised controlled trialMEDLINE-indexed journal, not yet read by usBrain, behavior, and immunity22 citations Mindfulness-based stress reduction increases stimulated IL-6 production among lonely older adults: A randomized controlled trial.
Loneliness is a potent psychosocial stressor that predicts poor health and mortality among older adults, possibly in part by accelerating age-related declines in immunocompetence. Mindfulness interventions have shown promise for reducing loneliness and improving markers of physical health. In a sample of lonely older adults, this two-arm parallel trial tested whether mindfulness training enhances stimulated interleukin-6 (IL-6) production, a measure of innate immune responsivity. Lonely older adults (65-85 years; N = 190) were randomized to an 8-week Mindfulness-Based Stress Reduction (MBSR) or control Health Enhancement Program (HEP) intervention. Lipopolysaccharide (LPS)-stimulated production of IL-6 was measured in vitro by blinded outcome assessors at pre-intervention, post-intervention, and 3-month follow-up. Mixed-effects linear models tested time (pre, post, follow-up) by conditio…
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Creswell JD, Irwin MR, Burklund LJ, Lieberman MD, Arevalo JM, Ma J, Breen EC, Cole SW (2012)randomised controlled trialMEDLINE-indexed journal, not yet read by usBrain, behavior, and immunity366 citations Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial.
Lonely older adults have increased expression of pro-inflammatory genes as well as increased risk for morbidity and mortality. Previous behavioral treatments have attempted to reduce loneliness and its concomitant health risks, but have had limited success. The present study tested whether the 8-week Mindfulness-Based Stress Reduction (MBSR) program (compared to a Wait-List control group) reduces loneliness and downregulates loneliness-related pro-inflammatory gene expression in older adults (N = 40). Consistent with study predictions, mixed effect linear models indicated that the MBSR program reduced loneliness, compared to small increases in loneliness in the control group (treatment condition × time interaction: F(1,35) = 7.86, p = .008). Moreover, at baseline, there was an association between reported loneliness and upregulated pro-inflammatory NF-κB-related gene expression in circul…
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The Silent Crisis: Loneliness in Older Adults-A Critical Review of Impacts, Strategies and Path Forward.
Background: Loneliness, distinct from social isolation, is a subjective sense of social disconnection exacerbating a public health crisis among older adults. Affecting ~33% of community-dwelling individuals aged 50-80 years post-COVID-19, it rivals smoking in mortality risk and drives cognitive, cardiovascular, and mental health declines. This review synthesises evidence to inform clinical strategies.
Methods: A critical review of per-reviewed meta-analyses, RCTs, and prospective cohorts literature (2019-2025) was conducted for adults aged 50 years and above. Studies were selected using validated loneliness or social isolation measures, with quality appraised via AMSTAR-2, Cochrane RoB 2, and Newcastle-Ottawa Scale; 34 studies met eligibility criteria from an initial yield of 1,847 records.
Results: Prevalence of loneliness stands at 29% isolation by 2024, highest among those with poor h…
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Li H, Xia N (2026)reviewMEDLINE-indexed journal, not yet read by usCurrent atherosclerosis reports Social Isolation, Loneliness and Subclinical Atherosclerosis.
Purpose of review: Social isolation and loneliness have emerged as important cardiovascular risk factors, yet the biological mechanisms linking adverse social experiences to cardiovascular disease remain incompletely understood. This review examines current evidence relating social isolation and loneliness to subclinical atherosclerosis and explores the underlying neuroendocrine, autonomic, inflammatory, and vascular mechanisms.
Recent findings: Recent epidemiological studies have associated social isolation and loneliness with endothelial dysfunction, arterial stiffness, carotid plaque, carotid intima-media thickness, and coronary artery calcium. Advances in transcriptomic and proteomic research have identified molecular signatures characterized by increased inflammatory signaling and altered immune regulation in socially isolated individuals. Experimental animal studies further support…
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Guglielmi V, Colangeli L, Parrotta ME, Ciammariconi A, Milani I, D'Adamo M, Sbraccia P, Capoccia D (2025)reviewMEDLINE-indexed journal, not yet read by usNutrition, metabolism, and cardiovascular diseases : NMCD4 citations Social isolation and loneliness in non-communicable chronic diseases: Impact of COVID-19 pandemic, population aging and technological progress.
Aims: Social isolation and loneliness have increasingly emerged as closely linked to onset and progression of non-communicable chronic diseases (NCDs). The aim of this review is to highlight the importance of addressing social isolation in the prevention and management of NCDs such as obesity, type 2 diabetes, and cardiovascular diseases in order to hinder their development and improve their outcomes.
Data synthesis: Social isolation and loneliness affect a significant portion of the older adult population, due to decrease in social interactions, chronic illnesses and sensory impairments. However, many other vulnerable populations may experience social isolation because of psychiatric or disabling health conditions, substances abuse, low socioeconomic status, unemployment and belonging to ethnic or marginalized minorities. The unprecedented COVID-19-related social distancing can be taken…
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Loneliness and social isolation in people with HIV.
Purpose of review: Antiretroviral therapy (ART) has significantly extended the life expectancy of people with HIV (PWH). However, as this population ages, they face increased risk of social isolation and loneliness (SIL), driven by stigma, discrimination, and shrinking social networks. SIL is a major public health issue, closely linked to mental health conditions, reduced adherence to treatment, and lower health-related quality of life (HRQoL). This review examines the prevalence, risk factors, health impacts, and interventions related to SIL, highlighting its critical importance for improving HRQoL in PWH.
Recent findings: SIL is common among PWH and strongly associated with HIV-related stigma, depression, anxiety, and systemic inflammation. These factors accelerate aging and contribute to chronic conditions while undermining ART outcomes. Recent research supports the effectiveness of i…
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Social isolation, loneliness, and mental health among older adults during COVID-19: a scoping review.
COVID-19 continues to have detrimental effects worldwide, especially on vulnerable populations. The burden of mental health concerns and psychological well-being resulting from social isolation and loneliness induced by COVID-19 are increasingly recognized in old age. The aim is to determine the extent of social isolation and loneliness among older adults, the methodologies used, the effect on mental health during COVID-19, and review intervention strategies and lifestyle changes to improve the current situation through the recommendations of the studies included. The articles published on PubMed, ProQuest, and Scopus databases from December 2019 to December 2021 with the following keywords ("Older Adults" "Social Isolation," "Loneliness," "Mental Health," "COVID-19") in English were included. Older adults have faced a serious burden of social isolation and adverse mental health effects …
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Exploring the impact of information and communication technologies on loneliness and social isolation in community-dwelling older adults: a scoping review of reviews.
Background: Recognizing the escalating public health concerns of loneliness and social isolation in aging populations, this study seeks to comprehensively explore the potential of information and communication technology (ICT)-based interventions to address these issues among older adults. This scoping review of reviews aims to map and synthesize existing evidence on the effectiveness and scope of ICT interventions targeting loneliness and social isolation in community-dwelling older adults, elucidating types of technology, impacts, facilitators, barriers, and research gaps.
Methods: Following the Joanna Briggs Institute framework, we systematically searched eight diverse databases identifying relevant published reviews. We included English-written, peer-reviewed reviews of all types, with no limits regarding time of publication about ICTs targeting loneliness and/or social isolation for…
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Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources.
Background: Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literat…
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Teshale AB, Htun HL, Hu J, Dalli LL, Lim MH, Neves BB, Baker JR, Phyo AZZ, Reid CM, Ryan J, Owen AJ, Fitzgerald SM, Freak-Poli R (2023)reviewMEDLINE-indexed journal, not yet read by usArchives of gerontology and geriatrics31 citations The relationship between social isolation, social support, and loneliness with cardiovascular disease and shared risk factors: A narrative review.
Background: Cardiovascular disease (CVD) is the greatest contributor to global morbidity and mortality. Poor social health plays a critical role in CVD incidence. Additionally, the relationship between social health and CVD may be mediated through CVD risk factors. However, the underlying mechanisms between social health and CVD are poorly understood. Certain social health constructs (social isolation, low social support and loneliness) have complicated the characterisation of a causal relationship between social health and CVD.
Aim: To provide an overview of the relationship between social health and CVD (and its shared risk factors).
Method: In this narrative review, we examined published literature on the relationship between three social health constructs (social isolation, social support, and loneliness) and CVD. Evidence was synthesised in a narrative format, focusing on the potent…
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Technology-Based Interventions to Address Social Isolation and Loneliness Among Informal Dementia Caregivers: A Scoping Review.
Objective: Social isolation and loneliness are major public health concerns. Informal dementia caregivers are particularly vulnerable, as many are older adults themselves and at elevated risk of adverse mental and physical health outcomes. Technology-based interventions could offer accessible, affordable, and convenient solutions. A previous review included Internet-based supportive interventions for informal dementia caregivers published up to 2013; however, new publications, technological advances, and targeted outcomes justify conducting this scoping review. Here, we identified and synthesized recent technology-based interventions that addressed social isolation and loneliness among informal dementia caregivers.
Design: Scoping review.
Setting and participants: Informal dementia caregivers in the community.
Methods: Following Arksey and O'Malley's scoping review framework, we conducte…
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Social isolation: An underappreciated determinant of physical health.
While a sizable body of research demonstrates the associations between social connection and health, much of the recent focus in the broader public and to some extent among academics has been on loneliness, with more objective/structural aspects often assumed to be proxies for more influential relationship factors such as relationship functions and quality. However, evidence suggests the actual presence of others (proximity and regular contact) is essential, and many studies document these structural indicators have just as powerful and, in some cases, more potent effects on indicators of health and well-being. This paper summarizes the evidence on social isolation and health and provides a framework for why social isolation may be a powerful predictor of health and mortality.
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Lee C, Kuhn I, McGrath M, Remes O, Cowan A, Duncan F, Baskin C, Oliver EJ, Osborn DPJ, Dykxhoorn J, Kaner E, Walters K, Kirkbride J, Gnani S, Lafortune L, NIHR SPHR Public Mental Health Programme (2022)reviewMEDLINE-indexed journal, not yet read by usHealth & social care in the community27 citations A systematic scoping review of community-based interventions for the prevention of mental ill-health and the promotion of mental health in older adults in the UK.
Background: Mental health concerns in older adults are common, with increasing age-related risks to physical health, mobility and social isolation. Community-based approaches are a key focus of public health strategy in the UK, and may reduce the impact of these risks, protecting mental health and promoting wellbeing. We conducted a review of UK community-based interventions to understand the types of intervention studied and mental health/wellbeing impacts reported.
Method: We conducted a scoping review of the literature, systematically searching six electronic databases (2000-2020) to identify academic studies of any non-clinical community intervention to improve mental health or wellbeing outcomes for older adults. Data were extracted, grouped by population targeted, intervention type, and outcomes reported, and synthesised according to a framework categorising community actions targe…
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Barriers and facilitators to the implementation of social robots for older adults and people with dementia: a scoping review.
Background: Psychosocial issues, such as social isolation and loneliness among older adults and people with dementia, continue to pose challenges with a rapidly aging population worldwide. Social robots are a rapidly emerging field of technology, developed to help address the psychosocial needs of this population. Although studies have reported positive findings regarding their psychosocial benefits, their implementation in real-world practice remains a challenge. Nevertheless, little is known about the factors affecting their implementation. The purpose of this review is to provide a systematic overview of the barriers and facilitators affecting the implementation of social robots for older adults and people with dementia.
Method: The Arksey and O'Malley approach with methodological enhancement by Levac et al. was used to guide the conduct of this review. Seven electronic databases were…
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Social Isolation and Psychological Distress Among Older Adults Related to COVID-19: A Narrative Review of Remotely-Delivered Interventions and Recommendations.
The COVID-19 pandemic is associated with several short- and long-term negative impacts on the well-being of older adults. Physical distancing recommendations to reduce transmission of the SARS-CoV2-19 virus increase the risk of social isolation and loneliness, which are associated with negative outcomes including anxiety, depression, cognitive decline, and mortality. Taken together, social isolation and additional psychological impacts of the pandemic (e.g., worry, grief) underscore the importance of intervention efforts to older adults. This narrative review draws upon a wide range of evidence to provide a comprehensive overview of appropriate remotely-delivered interventions for older adults that target loneliness and psychological symptoms. These include interventions delivered by a range of individuals (i.e., community members to mental health professionals), and interventions that v…
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Life in lockdown: Social isolation, loneliness and quality of life in the elderly during the COVID-19 pandemic: A scoping review.
Coronavirus disease-2019 (COVID-19) had an unprecedented effect all over the world, especially in older individuals. The aim is to evaluate the social isolation, loneliness and quality of life of elderly individuals during the COVID-19 pandemic and to map suggestions to reveal and improve the current situation. This was a scoping review. Articles since December 2019 to March 2021 published on PubMed, Scopus, ProQuest, Cochrane Library, CINAHL databases with the following MeSh terms ('COVID-19', 'coronavirus', 'quality of life' 'aging', 'older people', 'elderly', 'loneliness' and 'social isolation) in English were included. The research, by consensus, resulted in seven studies selected for full reading, including three descriptive and cross-sectional studies, a quasi-experimental study, a pre-post pilot program, an editorial note and a correspondence. In generally, these recommendations w…
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Loneliness and social isolation interventions for older adults: a scoping review of reviews.
Background: Loneliness and social isolation are growing public health concerns in our ageing society. Whilst these experiences occur across the life span, 50% of individuals aged over 60 are at risk of social isolation and one-third will experience some degree of loneliness later in life. The aim of this scoping review was to describe the range of interventions to reduce loneliness and social isolation among older adults that have been evaluated; in terms of intervention conceptualisation, categorisation, and components.
Methods: Three electronic databases (CINAHL, Embase and Medline) were systematically searched for relevant published reviews of interventions for loneliness and social isolation. Inclusion criteria were: review of any type, published in English, a target population of older people and reported data on the categorisation of loneliness and/or social isolation interventions…
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Li H, Xia N (2020)reviewMEDLINE-indexed journal, not yet read by usRedox biology122 citations The role of oxidative stress in cardiovascular disease caused by social isolation and loneliness.
Loneliness and social isolation are common sources of chronic stress in modern society. Epidemiological studies have demonstrated that loneliness and social isolation increase mortality risk as much as smoking or alcohol consumption and more than physical inactivity or obesity. Loneliness in human is associated with higher blood pressure whereas enhanced atherosclerosis is observed in animal models of social isolation. Loneliness and social isolation lead to activation of the hypothalamic-pituitary-adrenocortical (HPA) axis, enhanced sympathetic nerve activity, impaired parasympathetic function and a proinflammatory immune response. These mechanisms have been implicated in the development of cardiovascular disease conferred by social isolation although a causal relationship has not been established so far. There is evidence that oxidative stress is likely to be a key molecular mechanism …
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COVID-19 in the geriatric population.
Objectives: The global COVID-19 pandemic has caused rapid and monumental changes around the world. Older people, who already experience higher rates of social isolation and loneliness, are more susceptible to adverse effects as a result of the social distancing protocols enacted to slow the spread of COVID-19. Based on prior outbreaks, we speculate the detrimental outcomes and offer solutions.
Methods: Reviewing the literature on the detrimental effects of social isolation and loneliness and higher mortality in the older population. Utilizing psychological study outcomes from prior major outbreaks such as in SARS, Ebola, H1N1 influenza, and Middle East respiratory syndrome offer predictions and the susceptibility in the geriatric age group.
Results: Organizations such as the WHO, Centers for Disease Control, and American Association of Retired Persons have put measures in place to provid…
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Donovan NJ, Blazer D (2020)reviewMEDLINE-indexed journal, not yet read by usThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry383 citations Social Isolation and Loneliness in Older Adults: Review and Commentary of a National Academies Report.
The authors of this review both served on the National Academy of Science, Engineering, and Medicine Committee that produced the report, "Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System." In 2018, the AARP Foundation commissioned the National Academies to establish a committee to research and develop a report on social isolation and loneliness in persons 50 years of age and older. Emphasis was placed upon the role of the healthcare system in addressing this fundamental public health problem. The committee released the report in February 2020 as the Corona Virus Disease 2019 pandemic was beginning to spread to North America. In this review, the authors share central findings and conclusions from the report as well as how these findings may be relevant to the care and well-being of older adults during this historic pandemic. The health protective b…
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