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. 2019 Feb 7;8(1):48.
doi: 10.1186/s13643-019-0968-x.

Loneliness and social isolation causal association with health-related lifestyle risk in older adults: a systematic review and meta-analysis protocol

Martin Malcolm  1 , Helen Frost  2 , Julie Cowie  3
Affiliations

Loneliness and social isolation causal association with health-related lifestyle risk in older adults: a systematic review and meta-analysis protocol

Martin Malcolm et al. Syst Rev. .

Abstract

Background: The health impacts of loneliness and social isolation among older adults are widely acknowledged. Despite this, there is no consensus on the possible causal nature of this relationship, which could undermine effectiveness of interventions. One body of thought is that loneliness and social isolation affect health-related behaviours to indirectly damage health. However, there has not been any systematic assessment of the association between loneliness and social isolation and health-related behaviours which considers the possible impact from confounding factors and the causal direction of this association.

Methods/design: The research will comprise a systematic review and meta-analysis to address the evidence gap. EMBASE, MEDLINE, PSYCINFO, CINAHL, SocIndex, Scopus and Web of Science will be systematically searched for quantitative observational studies considering an association between loneliness/social isolation and key health-related behaviours in older adults. Two reviewers will independently check the study titles and abstracts for eligibility. Included studies will be critically appraised using Newcastle-Ottawa Scale by the lead author and checked by the second reviewer. Discrepancies in eligibility or quality assessment will be resolved via discussion or referral to a third reviewer. Results will be synthesised and reported in accordance with the Centre for Reviews and Dissemination (CRD) guidelines. This will be in the form of a descriptive summary, risk of bias assessment together with a meta-analysis and sub-group analyses (for covariate adjusted results) where sufficient heterogeneity of results is established. Finally, any associations identified will be analysed using the Bradford-Hill criteria to explore causal relationships which, if they exist, will be reported by means of a computed causations score.

Discussion: This review aims to assess the extent and causal nature of associations between loneliness/social isolation and health-related behaviours among older adults. This data will provide a comprehensive overview of the quality of the evidence base to inform stakeholders in tackling the growing public health challenges arising from loneliness/social isolation in ageing populations.

Systematic review registration: PROSPERO CRD42017020845.

Keywords: Alcohol; Health behaviours; Loneliness; Meta-analysis; Obesity; Older adults; Physical activity; Smoking; Social isolation; Systematic review.

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Conflict of interest statement

Author’s information

The principal author, MM, has undertaken this study as part fulfilment of his research doctorate study.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Green BH, Copeland JR, Dewey ME, Sharma V, Saunders PA, Davidson IA, et al. Risk factors for depression in elderly people: a prospective study. Acta Psychiatr Scand. 1992;86(3):213–217. doi: 10.1111/j.1600-0447.1992.tb03254.x. - DOI - PubMed
    1. Prince MJ, Harwood RH, Blizard RA, Thomas A, Mann AH. Social support deficits, loneliness and life events as risk factors for depression in old age. The Gospel Oak Project VI. Psychol Med 1997;27(2):323–32. - PubMed
    1. Heikkinen R, Kauppinen M. Depressive symptoms in late life: a 10-year follow-up. Arch Gerontol Geriatr. 2004;38(3):239–250. doi: 10.1016/j.archger.2003.10.004. - DOI - PubMed
    1. Cacioppo JT, Hughes ME, Waite LJ, Hawkley LC, Thisted RA. Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychol Aging. 2006;21(1):140–151. doi: 10.1037/0882-7974.21.1.140. - DOI - PubMed
    1. Cacioppo JT, Hawkley LC, Thisted RA. Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychol Aging. 2010;25(2):453–463. doi: 10.1037/a0017216. - DOI - PMC - PubMed

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