Interventions for social isolation in older adults who have experienced a fall: a systematic review

Objectives The objective of our systematic review was to identify the effective interventions to prevent or mitigate social isolation and/or loneliness in older adults who experienced a fall. Design Systematic review. Data sources MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Ageline were searched (from inception to February 2020). Methods Studies were eligible if they described any intervention for social isolation in older adults living in a community setting who experienced a fall, and reported outcomes related to social isolation or loneliness. Two independent reviewers screened citations, abstracted data and appraised risk of bias using the Cochrane risk of bias tool. The results were summarised descriptively. Results After screening 4069 citations and 55 full-text articles, four studies were included. The four studies varied in study design, including a randomised controlled trial, non-randomised controlled trial, an uncontrolled before-after study and a quasiexperimental study. Interventions varied widely, and included singing in a choir, a patient-centred, interprofessional primary care team-based approach, a multifactorial assessment targeting fall risk, appropriate medication use, loneliness and frailty, and a community-based care model that included comprehensive assessments and multilevel care coordination. Outcome measures varied and included scales for loneliness, social isolation, social interaction, social networks and social satisfaction. Mixed results were found, with three studies reporting no differences in social isolation or loneliness after the intervention. Only the multifactorial assessment intervention demonstrated a small positive effect on loneliness compared with the control group after adjustment (B=-0.18, 95% CI -0.35 to -0.02). Conclusions Few studies examined the interventions for social isolation or loneliness in older adults who experienced a fall. More research is warranted in this area. PROSPERO registration number CRD42020198487.

Automated summary

This systematic review aimed to identify effective interventions to prevent or mitigate social isolation and/or loneliness in older adults who experienced a fall. Four studies were included, each with different study designs and interventions. The results showed mixed effects, with three studies reporting no differences in social isolation or loneliness after the interventions. Only the multifactorial assessment intervention demonstrated a small positive effect on loneliness. However, there is still limited research examining interventions for social isolation or loneliness in this particular population, indicating a need for further studies.