Effectiveness of Technology Interventions in Addressing Social Isolation, Connectedness, and Loneliness in Older Adults : A Systematic Umbrella Review

Balki, Eric and Hayes, Niall and Holland, Carol (2022) Effectiveness of Technology Interventions in Addressing Social Isolation, Connectedness, and Loneliness in Older Adults : A Systematic Umbrella Review. JMIR Aging, 5 (4): e40125. ISSN 2561-7605

Abstract

Background: Global population of older adults (aged >60y) is expected to triple to 2 billion by 2050. Proportionate rises in the number of older adults affected by loneliness and social isolation (or social disconnectedness) is expected. Rapid deployability, and social changes, have increased availability of technological devices, creating new opportunities for older adults. Objective: This study aimed to identify, synthesize, and critically appraise the effectiveness of technological interventions on social disconnectedness in older adults to assess the quality of reviews, common observations, and derivable themes. Methods: Following guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, four databases (PsychINFO, PubMed, Embase, and Medline) were searched between February 2020 and March 2022. We identified reviews with adults aged ≥50 years in community and residential settings, reporting outcomes related to the impact of technologies on social connectedness, loneliness and isolation with inclusion criteria based upon the PICOS (population, intervention, comparison/context, outcomes, and study) schema, with review type articles (systematic, meta-analyses, integrative and scoping), and those with digital interventions included. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to measure the strength of outcome recommendations including risk of bias. Reviews covered 425 primary studies with 79,538 participants. Findings were extracted, synthesised and organised according to emerging themes. Results: 972 publications met initial search criteria; 27 met our inclusion criteria. Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) was used to assess quality of analysis. Eligible reviews (n = 3) were excluded because of low R-AMSTAR scores (n < 22). The reviews were dedicated to general information and communication technology (ICT) (n = 11), videoconferencing (n = 4), computer/Internet training (n = 3), telecare (n = 2), social networking sites (SNS) (n = 2), and robotics (n = 2). Although technology was found to improve social connectedness, its effectiveness depends on the study design and is improved by shorter study duration, longer training times, and facilitation of existing relationships. General ICT and videoconferencing showed the most promising results, followed by computer training. SNS achieved mixed results. Robotics and augmented reality showed promising results but lacked sufficient data for informed conclusions. The overall quality of the GRADE was medium-low to very-low. Conclusions: Technological interventions can potentially improve social connectedness in older adults. The specific effectiveness rates favor general ICT and videoconferencing, but with limited evidence, indicated by low GRADE ratings. Future intervention and study design guidelines should carefully assess the methodological quality of studies and the overall certainty of specific outcome measures. The lack of randomized control trials in underlying primary studies (< 28%), and suboptimal methdologies limited our findings. Robotics and augmented/virtual reality show promise and warrant further research. Low GRADE scores highlight the need for high-quality research in these areas.