The Effectiveness of Technology-Based Interventions for Reducing Loneliness in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective: To systematically analyze the effectiveness of technology-based interventions for reducing loneliness in older adults.

Methods: We searched relevant electronic databases from inception to April 2021, which included Cochrane Library, PubMed, Web of Science, SpringerLink, EMBASE, CNKI, and Wanfang. The following criteria were used: (i) study design—randomized controlled trial (RCT) designs, (ii) people—older adults (aged ≥ 60 years), (iii) intervention—technology-based interventions in which a core component involved the use of technology to reduce loneliness in older adults; and (iv) outcome—reduction of loneliness level in terms of rating scale scores. Two reviewers independently identified eligible studies, extracted data, and assessed the risk of bias in the included studies. A third reviewer resolved any conflicts. The Cochrane Collaboration's bias assessment tool was used to evaluate the risk of bias for the included studies, and Review Manager 5.4 software was used for the meta-analysis. A random effects model was adopted to measure estimates of loneliness reduction, and standard mean differences (SMD) with a 95% confidence interval (CI) were calculated for each intervention-control contrast, and the I² statistic was applied to examine heterogeneity.

Results: A total of 391 participants from six RCTs were included in the review. Of these, three studies were rated as low-quality, and the remaining three were rated as moderate-quality studies. The meta-analysis showed that the evidence regarding the effects on loneliness of technology-based interventions compared with control groups was uncertain, and suggested that technology-based interventions resulted in little to no difference in loneliness reduction compared to control groups (SMD = −0.08, 95% CI −0.33 to 0.17, p = 0.53). Two types of technology-based interventions were identified: smartphone-based video calls and computer-based training with Internet usage. The subgroup analysis found low-quality evidence to support the effectiveness of both intervention types (SMD = −0.01, 95% CI −0.25 to 0.24, p = 0.95, and SMD = −0.38, 95% CI −0.19, 0.64, p = 0.47, respectively).

Conclusions: We found no current evidence to support that technology-based interventions were effective compared to different control conditions in reducing loneliness in older adults. This suggests that more research is needed to investigate the effects of technology-based interventions on loneliness in older adults.

Development of an integrated staircase lift for home access

PURPOSE

Stairways into buildings present a significant environmental barrier for those with mobility impairments, including older adults. A number of home access solutions that allow users to safely enter and exit the home exist, however these all have some limitations. The purpose of this work was to develop a novel, inclusive home access solution that integrates a staircase and a lift into one device.

METHOD

The development of an integrated staircase lift followed a structured protocol with stakeholders providing feedback at various stages in the design process, consistent with rehabilitation engineering design methods.

RESULTS

A novel home access device was developed. The integrated staircase-lift has the following features: inclusivity, by a universal design that provides an option for either use of stairs or a lift; constant availability, with a lift platform always ready for use on either level; and potential aesthetic advantages when integrating the device into an existing home. The potential also exists for emergency descent during a power outage, and self-powered versions.

CONCLUSIONS

By engaging stakeholders in a user centred design process, insight on the limitations of existing home access solutions and specific feedback on our design guided development of a novel home access device.

User perceptions of existing home access solutions and a novel home access device

PURPOSE

This study aimed to evaluate end user perspectives of four existing home access solutions (HAS) and a newly designed experimental device (the ARISE).

METHOD

A cross-sectional design was used to evaluate the ARISE prototype against other HAS. Specifically, participants trialed stairs, a ramp, a platform lift (PL), a stair glide and the ARISE, after which they completed questionnaires aimed at soliciting their perspectives of these solutions. The time taken by participants to use each HAS was also collected.

RESULTS

Five HAS design features were deemed as important by 90% of participants: ease of use, ability to use independently, reliability, safety and security. Time taken to use each HAS from fastest to slowest was: stairs, the ARISE, ramp, PL and stair glide. The ARISE prototype was rated as the first or second most preferred device by the most number of participants, followed by the PL, then the ramp.

CONCLUSIONS

Results from this study provide greater understanding of user perspectives of HAS. End user feedback on a novel prototype device has provided valuable insight into its usability and function, which should not only guide future development of this device, but also provide direction for other innovations around home access. Implications for Rehabilitation It is anticipated that gaining a better understanding of strengths and weaknesses of home access solutions will: assist clinicians and end users in finding solutions that meet the individuals' needs. lead to the development of new or improved solutions that more closely address user needs. encourage further innovation in the area.