Conceptualising the context and mechanisms for tackling loneliness in older adults through interventions: A Critical Interpretive Synthesis

J. Ratcliffe; F. Matcham; E. Molteni; M. Antonelli; J. Rees; Y. Shi; J. Liu; S. Ourselin; A. Tinker; Y. Zhou; Wei Liu

doi:10.1101/2025.01.06.25320003

Conceptualising the context and mechanisms for tackling loneliness in older adults through interventions: A Critical Interpretive Synthesis

J. Ratcliffe, F. Matcham, E. Molteni, M. Antonelli, J. Rees, Y. Shi, J. Liu, S. Ourselin, A. Tinker, Y. Zhou, Wei Liu^*

^*Corresponding author for this work

Research output: Working paper/Preprint › Preprint

Abstract

BackgroundLoneliness in later life has been widely associated with poor mental and physical health. However, despite many reviews, current evidence does not provide a clear picture of how to tackle loneliness in older adults through interventions. Research examining the contexts and mechanisms for reducing loneliness through interventions is required to identify how, why, and for who interventions work or do not work. MethodsA critical interpretive synthesis, a review method designed to rigorously and reflexively re-examine existing literature, was conducted to re-consider and identify what matters in interventions. This was enacted through a broad search strategy incorporating database searches, contacting experts, reference-chaining, and team discussions, enabling a flexible and iterative review able to generate new theory. Results274 papers were included in the analysis. We identified four dimensions to whether and how interventions worked. Intended outcome mirrored different theoretical perspectives on how to reduce loneliness. Four intended outcomes were identified: cognitive change; improved social connections; physiological change; and a more meaningful life. The second dimension was the level of an intervention - whether it intended to intervene at a micro, meso, or macro level. Thirdly, 13 positive features of interventions were noted to have been evidenced to lead to or constitute more effective interventions. These were interventions that are organised, adaptable, have good staff/volunteers, provide support to attend, routinised, built on shared interests/identities, personalised, culturally aware, co-produced, involve active participation, strengths-based, lasting, and targeted at the appropriate people. Lastly, nine emotions that represent less loneliness were identified: a feeling of reciprocated interactions; emotional and social support; belonging; perspective; self-efficacy; mattering; pride; purpose; and empowerment. ConclusionsInterventions and evaluations should look beyond comparing activities to see which are best and recognise that multidimensionality and variation is vital for individuals and communities with different needs. Identifying what the intended outcome of an intervention is, what level of society it intends to impact, and whether it actions the positive features identified in this study, can be employed to better target the variety of emotions that represent less loneliness.

Original language	Undefined/Unknown
DOIs	https://doi.org/10.1101/2025.01.06.25320003
Publication status	Published - 2025

Keywords

psychiatry and clinical psychology

Access to Document

10.1101/2025.01.06.25320003Licence: CC BY

Cite this

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title = "Conceptualising the context and mechanisms for tackling loneliness in older adults through interventions: A Critical Interpretive Synthesis",

abstract = "BackgroundLoneliness in later life has been widely associated with poor mental and physical health. However, despite many reviews, current evidence does not provide a clear picture of how to tackle loneliness in older adults through interventions. Research examining the contexts and mechanisms for reducing loneliness through interventions is required to identify how, why, and for who interventions work or do not work. MethodsA critical interpretive synthesis, a review method designed to rigorously and reflexively re-examine existing literature, was conducted to re-consider and identify what matters in interventions. This was enacted through a broad search strategy incorporating database searches, contacting experts, reference-chaining, and team discussions, enabling a flexible and iterative review able to generate new theory. Results274 papers were included in the analysis. We identified four dimensions to whether and how interventions worked. Intended outcome mirrored different theoretical perspectives on how to reduce loneliness. Four intended outcomes were identified: cognitive change; improved social connections; physiological change; and a more meaningful life. The second dimension was the level of an intervention - whether it intended to intervene at a micro, meso, or macro level. Thirdly, 13 positive features of interventions were noted to have been evidenced to lead to or constitute more effective interventions. These were interventions that are organised, adaptable, have good staff/volunteers, provide support to attend, routinised, built on shared interests/identities, personalised, culturally aware, co-produced, involve active participation, strengths-based, lasting, and targeted at the appropriate people. Lastly, nine emotions that represent less loneliness were identified: a feeling of reciprocated interactions; emotional and social support; belonging; perspective; self-efficacy; mattering; pride; purpose; and empowerment. ConclusionsInterventions and evaluations should look beyond comparing activities to see which are best and recognise that multidimensionality and variation is vital for individuals and communities with different needs. Identifying what the intended outcome of an intervention is, what level of society it intends to impact, and whether it actions the positive features identified in this study, can be employed to better target the variety of emotions that represent less loneliness.",

keywords = "psychiatry and clinical psychology",

author = "J. Ratcliffe and F. Matcham and E. Molteni and M. Antonelli and J. Rees and Y. Shi and J. Liu and S. Ourselin and A. Tinker and Y. Zhou and Wei Liu",

year = "2025",

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T1 - Conceptualising the context and mechanisms for tackling loneliness in older adults through interventions: A Critical Interpretive Synthesis

AU - Ratcliffe, J.

AU - Matcham, F.

AU - Molteni, E.

AU - Antonelli, M.

AU - Rees, J.

AU - Shi, Y.

AU - Liu, J.

AU - Ourselin, S.

AU - Tinker, A.

AU - Zhou, Y.

AU - Liu, Wei

PY - 2025

Y1 - 2025

N2 - BackgroundLoneliness in later life has been widely associated with poor mental and physical health. However, despite many reviews, current evidence does not provide a clear picture of how to tackle loneliness in older adults through interventions. Research examining the contexts and mechanisms for reducing loneliness through interventions is required to identify how, why, and for who interventions work or do not work. MethodsA critical interpretive synthesis, a review method designed to rigorously and reflexively re-examine existing literature, was conducted to re-consider and identify what matters in interventions. This was enacted through a broad search strategy incorporating database searches, contacting experts, reference-chaining, and team discussions, enabling a flexible and iterative review able to generate new theory. Results274 papers were included in the analysis. We identified four dimensions to whether and how interventions worked. Intended outcome mirrored different theoretical perspectives on how to reduce loneliness. Four intended outcomes were identified: cognitive change; improved social connections; physiological change; and a more meaningful life. The second dimension was the level of an intervention - whether it intended to intervene at a micro, meso, or macro level. Thirdly, 13 positive features of interventions were noted to have been evidenced to lead to or constitute more effective interventions. These were interventions that are organised, adaptable, have good staff/volunteers, provide support to attend, routinised, built on shared interests/identities, personalised, culturally aware, co-produced, involve active participation, strengths-based, lasting, and targeted at the appropriate people. Lastly, nine emotions that represent less loneliness were identified: a feeling of reciprocated interactions; emotional and social support; belonging; perspective; self-efficacy; mattering; pride; purpose; and empowerment. ConclusionsInterventions and evaluations should look beyond comparing activities to see which are best and recognise that multidimensionality and variation is vital for individuals and communities with different needs. Identifying what the intended outcome of an intervention is, what level of society it intends to impact, and whether it actions the positive features identified in this study, can be employed to better target the variety of emotions that represent less loneliness.

AB - BackgroundLoneliness in later life has been widely associated with poor mental and physical health. However, despite many reviews, current evidence does not provide a clear picture of how to tackle loneliness in older adults through interventions. Research examining the contexts and mechanisms for reducing loneliness through interventions is required to identify how, why, and for who interventions work or do not work. MethodsA critical interpretive synthesis, a review method designed to rigorously and reflexively re-examine existing literature, was conducted to re-consider and identify what matters in interventions. This was enacted through a broad search strategy incorporating database searches, contacting experts, reference-chaining, and team discussions, enabling a flexible and iterative review able to generate new theory. Results274 papers were included in the analysis. We identified four dimensions to whether and how interventions worked. Intended outcome mirrored different theoretical perspectives on how to reduce loneliness. Four intended outcomes were identified: cognitive change; improved social connections; physiological change; and a more meaningful life. The second dimension was the level of an intervention - whether it intended to intervene at a micro, meso, or macro level. Thirdly, 13 positive features of interventions were noted to have been evidenced to lead to or constitute more effective interventions. These were interventions that are organised, adaptable, have good staff/volunteers, provide support to attend, routinised, built on shared interests/identities, personalised, culturally aware, co-produced, involve active participation, strengths-based, lasting, and targeted at the appropriate people. Lastly, nine emotions that represent less loneliness were identified: a feeling of reciprocated interactions; emotional and social support; belonging; perspective; self-efficacy; mattering; pride; purpose; and empowerment. ConclusionsInterventions and evaluations should look beyond comparing activities to see which are best and recognise that multidimensionality and variation is vital for individuals and communities with different needs. Identifying what the intended outcome of an intervention is, what level of society it intends to impact, and whether it actions the positive features identified in this study, can be employed to better target the variety of emotions that represent less loneliness.

KW - psychiatry and clinical psychology

U2 - 10.1101/2025.01.06.25320003

DO - 10.1101/2025.01.06.25320003

M3 - Preprint

BT - Conceptualising the context and mechanisms for tackling loneliness in older adults through interventions: A Critical Interpretive Synthesis

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