Effectiveness of Technology Interventions in addressing Social Isolation, Connectedness, and Loneliness in Older Adults: A systematic Umbrella Review (Preprint)
Authors: Balki Eric , Hayes Niall , Holland Carol 
Published: June 2022

BACKGROUND

The present global population of older adults (aged >60 years) is expected to triple to 2 billion by 2050. A proportionate rise in the number of older adults affected by loneliness and social isolation (or social disconnectedness) is expected. Rapid deployability, along with social changes, have increased the availability of technological devices, creating new opportunities for older adults.

OBJECTIVE

This study aims to identify, synthesize, and critically appraise the effectiveness of technological interventions on social disconnectedness in older adults. To this end, it assesses the quality of reviews, common observations, and derivable themes.

METHODS

Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, four databases were comprehensively searched between February, 2020 and March, 2022. The databases (PsychINFO, PubMed, EMBASE, and Medline) were searched for systematic reviews, meta-analyses, and integrative and scoping reviews. The quality and quality of evidence of each analysis were assessed using the R-AMSTAR (Revised Assessment of Multiple Systematic Reviews) and GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was used to was used to measure the strength of outcome recommendations across this umbrella review.

RESULTS

Among 972 publications identified in our initial search, 27 were included following assessment for adherence to our inclusion criteria. Three of the eligible reviews were excluded due to low R-AMSTAR scores (n<22). The reviews covered 425 primary studies on the impacts of technological interventions on loneliness, social isolation, connectedness, and quality of life of 79,538 participants. The reviews were dedicated to general information and communication technology (ICT) (11 reviews), videoconferencing (four reviews), computer/internet training (three reviews), telecare (two reviews), social networking sites (SNS) (two reviews), and robotics (two reviews). 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 (being relatively novel) lack sufficient data for drawing informed conclusions. The overall quality of the evidence (GRADE assessment) was medium–low to very low.

CONCLUSIONS

Technological interventions can potentially improve social connectedness in older adults. The specific effectiveness rates favored general ICT and videoconferencing as intervention techniques but evidence is limited, as indicated by the low GRADE ratings. Future intervention and study design guidelines should be updated for carefully assessing the methodological quality of studies and the overall certainty of specific outcome measures. Suboptimal methodologies and lack of randomized control trials in underlying primary studies (<28%), and the limited conclusions reviews could find, limited our findings. Robotics and augmented/virtual reality, currently in their infancy, show promise and warrant further research.