# Psychosocial and therapeutic interventions for improving mental health and reducing feelings of loneliness among older adults - Savonia AMK

> A review of evidence-based interventions for older adults, utilizing the PEDro Scale to evaluate the effectiveness of psychosocial support in reducing loneliness and improving mental health.

## Introduction
Feelings of loneliness are a significant global problem for older adults. As the population ages, addressing the social and emotional needs of this demographic has become increasingly important. A wide variety of face-to-face or digital interventions have been developed to reduce social isolation and loneliness, including social skills training, community and support groups, befriending, and cognitive behavioural therapy. Creating age-friendly communities by improving access to transportation and information and communication technologies can also help.

## Purpose and Methodology
This article is a learning assignment from the professional in physiotherapy course at Savonia University of Applied Sciences, focusing on evidence-based practice. The purpose was to practice using the PEDro Scale to evaluate research.

*   **PICO Question:** Which of the selected psychosocial or therapeutic interventions are most effective in improving mental health and reducing feelings of loneliness among older adults?
*   **Databases:** PubMed and PEDro.
*   **Search Terms:** “Socialization AND elderly”.
*   **Inclusion Criteria:** Randomized control trials (RCTs) published in the last five years.

The PEDro Scale (1999) was used to evaluate methodological quality, assessing criteria such as random allocation, blinding, and statistical comparisons. Studies scoring six or more out of 10 were considered high quality, while those below six were categorized as moderate to low.

## Review of Selected Studies
Three randomized control trials were selected for this review:

*   **Hernández-Ascanio et al. (2023):** Examined a multicomponent intervention (home-based sessions and telephone calls). While the program did not significantly reduce overall social isolation or loneliness, detailed analysis showed an increase in confidential support and a decrease in emotional loneliness.
*   **Jesus et al. (2024):** Evaluated the HEPPI (Homebound Elderly People Psychotherapeutic Intervention) program, which proved effective in reducing loneliness and alleviating depressive symptoms among homebound individuals.
*   **Sturm et al. (2022):** Evaluated the HoPES3 (Holistic Care Program for Elderly Patients) program. Results showed effectiveness in supporting spirituality, social activity, and independence, which improved the participants' quality of life.

## Discussion and Conclusion
Among the interventions, the HEPPI program demonstrated the most immediate and significant reduction in loneliness and depressive symptoms. However, the lack of sustained effects across the studies highlights the importance of continuous support and tailoring interventions to individual needs. All three studies scored approximately 6 out of 10 on the PEDro Scale, indicating moderate methodological quality. These findings suggest that a comprehensive approach addressing social, emotional, and spiritual factors produces the best outcomes, though there is a need for larger, long-term studies in physiotherapy research.

## Authors
*   **Mirella Karttunen**, physiotherapy student, Savonia University of Applied Sciences
*   **Marja Äijö**, PhD, Principal Lecturer of Gerontology and Rehabilitation, Savonia University of Applied Sciences

## References
*   Canva. (n.d.). [Kuva]. In available: https://www.canva.com/
*   Hernández-Ascanio, J., Perula-de Torres, L. Á., Rich-Ruiz, M., González-Santos, J., Mielgo-Ayuso, J., González-Bernal, J., & ASyS Study Collaborative Group (2023). Effectiveness of a multicomponent intervention to reduce social isolation and loneliness in community-dwelling elders: A randomized clinical trial. Nursing open, 10(1), 48–60. https://doi.org/10.1002/nop2.1277
*   Jesus, A. G., de Lima, M. P., Vilar, M., & Pachana, N. A. (2024). Homebound elderly people psychotherapeutic intervention (HEPPI): Exploring the mediating role of loneliness. Archives of gerontology and geriatrics, 118, 105308. https://doi.org/10.1016/j.archger.2023.105308
*   National Academies of Sciences, Engineering, and Medicine. (2020). Social isolation and loneliness in older adults: opportunities for the health care system. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663
*   PedroScale (1999). Pedro Scale tool. https://pedro.org.au/english/resources/pedro-scale/
*   Social isolation and loneliness among older people: advocacy brief. (2021). Geneva: World Health Organization. Licence: CC BY-NC-SA 3.0 IGO.
*   Sturm, N., Krisam, J., Szecsenyi, J., Bentner, M., Frick, E., Mächler, R., Schalhorn, F., Stolz, R., Valentini, J., Joos, S., & Straßner, C. (2022). Spirituality, Self-Care, and Social Activity in the Primary Medical Care of Elderly Patients. Deutsches Arzteblatt international, 119(8), 124–131. https://doi.org/10.3238/arztebl.m2022.0078
*   World Health Organization. (n.d.). Reducing social isolation and loneliness among older people. https://www.who.int/activities/reducing-social-isolation-and-loneliness-among-older-people