Are digital technology interventions effective to reduce loneliness in older adults? A systematic review and meta-analysis

ABSTRACT ObjectiveTo review the latest literature on the effectiveness of DTIs in reducing loneliness in (older) adults. Data SourcesElectronic searches in PubMed, Medline, CINAHL, EMBASE and Web of Science covering publication period from 1 January 2010 to 31 July 2019. SubjectsAdult men and women DesignSystematic review and meta-analysis Main Outcome MeasureLoneliness. Study SelectionPrimary studies that used DTIs for tackling loneliness in adults (aged ≥18 years) with follow-up measurements at least three months or more and publication in the English language. Data Extraction and SynthesisTwo researchers independently screened articles and extracted data on several variables: participants, interventions, comparators and outcomes. Data was extracted on the primary outcome i.e. loneliness measured at the baseline and follow-up measurements at three, four, six and twelve months after the intervention. ResultsSix studies were selected from 4939 articles screened. Selected studies included 5 clinical trials (4 RCTs and 1 quasi experimental study) and one before and after study, which enrolled 646 participants (men =154 (24%), women =427 (66%), no gender information =65 (10%) with average age between 73 and 78 years (SD 6-11). Five clinical trials were included in the meta-analysis and standardised mean differences (SMD) were calculated for each trial and pooled across studies using a random effects model. The overall effect estimates were not statistically significant in follow-up measurements at three months (SMD= 0.02, 95% CI= ?0.36, 0.40; P=0.92), four months (SMDs= ?1.11, 95% CI= - 2.60, 0.38; P=0.14) and six months (SMD= ?0.11, 95% CI= ?0.54, 0.32; P=0.61). The quality of evidence was very low to moderate in these trials. ConclusionsThere is insufficient evidence to make conclusions that DTIs are effective in reducing loneliness in older adults. Future research may consider RCTs with larger sample sizes and longer duration of interventions and follow-up.