Background
Methods
Study selection
Inclusion criteria | Exclusion criteria | |
---|---|---|
Population | All populations and age groups | |
Outcome of interest | Loneliness and/or social isolation | |
Type of study | Quantitative studies (cross-sectional, longitudinal, cohort, etc.), reported the scores of utility weights relating to loneliness or social isolation | Qualitative studies |
Utility instrument | Both direct elicitation methods and indirect utility valuation methods | |
Country | All countries | |
Publication type | Published in peer-reviewed journals | Protocol papers, conference abstracts, reviews, expert opinion and editorials |
Year of Publication | No restriction | |
Language | English Language | Other Language |
Data extraction
Results
Study characteristics
Utility | Loneliness | Social isolation | |||
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Measure | # | Measure | # | Measure | # |
EQ-5D (-3L/-5L) | UCLA LS 20 item | Lubben Social Network Scale-revised | 1 [36] | ||
AQoL-8D | Six-item De Jong Gierveld Loneliness Scale | 1 [47] | The Lubben Social Network Scale- 6 item | ||
HUI2 | 1 [44] | De Jong Gierveld Loneliness Scale 11-item scale | Friendship Scale | ||
HUI3 | 1 [36] | R-UCLA LS 3 item | Social inclusion | 1 [33] | |
15D | 1 [48] | R-UCLA LS 20 item | 1 [33] | Social health battery | 1 [38] |
EQ-5D + SF-6D | 1 [38] | Single question |
Author, Country | Population characteristics | Study design (Sample size) | Reported health conditions | Utility instrument (tariff used) | Loneliness measure | Overall population mean loneliness score (SD) mean utility (U) score (SD) | Mean utility score (U) for those ‘not lonely’, ‘lonely’ and by levels of loneliness* | |||||
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Not lonely | Lonely | Low loneliness | Moderate loneliness | Moderately High loneliness | ||||||||
Zhu et al., China [32] | ≥ 60 years, mean age (SD): 71 (7.73) Community-dwelling women: 51%, Married: 64%, Empty nester: 46.6% | Cross-sectional design (n = 732) | Chronic disease 76.4% | EQ-5D-3L (Chinese general population) | 20-item UCLA LSa | 40.73 (8.73) U: 0.93 (0.12) | 20–34: U: 0.97 | 35–49: U: 0.93 | 50–64:b U: 0.86 | |||
Ko et al., South Korea [46] | ≥ 60 years, mean age (SD): 77 (5.87) Women: 78% All Living alone Widowed: 76% | Cross-sectional design (n = 1023) | Mild to severe cognitive impairment: 57.2% Moderate depression 26% | EQ-5D-3L (UK general population) | 20-item UCLA LSa | 41.54 (13.12) U: 0.81 (0.18) | 35–49c 41.54 U: 0.81 | |||||
Rodriguez-Blazquez et al., Spain [47] | ≥ 60 years older adults Non-institutionalised group mean age (SD): 72 (8.16) Without partner:43% Women: 58% Institutionalised group mean age (SD: 81 (7.06) Without partner:81% Women: 65% | Cross-sectional design (n = 468) | Mean number of medical conditions (SD) Non-institutionalised 3.57 (2.62) Institutionalised 6.50 (2.79) | EQ-5D-3L (not stated) | 6-item De Jong Gierveld loneliness Scale d | Non- institutionalised 2.02 (1.81) U: 0.81 (0.26) | Institutionalised 2.54 (1.58) U: 0.57 (0.36) | 2–6:d 2.02 U: 0.81 2.54 U: 0.57 | ||||
≥ 75 years: mean age (SD): 80 (4) Home dwelling Women: 73% Widowed: 68% | RCT for psychosocial group intervention to explore HRQoL (n = 235) | Having subjective feelings of loneliness and numerous health conditions | 15D (not stated) | Study specific single question f | NR U: 0.78 (0.12) g | Yes: U: 0.78 | ||||||
Taube et al., Sweden [49] | ≥ 65 years, mean age (SD): 82 (6.4) Women: 67% All Home dwelling Not lonely sample (n = 61) mean age (SD): 81 (6.5) Windowed 21.3% Lonely sample (n = 61) mean age (SD): 82 (6.2) Windowed 67.4% | Cross-sectional design (n = 153) Not Lonely (n = 61) Lonely (n = 92) | Dependency in daily activities, repeated contacts with the health care services Not lonely: No of health complaints: 9.8 (4.7) Lonely: No of health complaints: 12.1 (4.6) | EQ-5D-3L (UK general population) | Study specific single question (Yes/No) h | NR U: 0.59 (0.27) | No: U: 0.63 | Yes: U: 0.56 | ||||
Van Houwelingen et al., Netherland [42] | ≥ 75 years median age 82 All Home dwelling Living alone 55 Widowed 53% Women: 68% | RCT to assess efficacy of a simple structural monitoring system to detect deterioration in the functional, somatic, mental or social health of individuals (n = 2713) | No. of chronic diseasesi median (IQR): 4 (3–6) | EQ-5D-3L (UK general population) | 11-item De Jong Gierveld Loneliness Scale j | Problems Functional:k 3 U: 0.65 Somatic: 2 U: 0.69 Mental: 3 U: 0.69 Social 4 U: 0.72 | No problems Functional: 2 U: 0.81 Somatic: 1 U: 0.84 Mental: 1 U: 0.81 Social 1 U: 0.81 | 0–2 j 2 U: 0.81 2 U: 0.69 1 U: 0.84 1 U: 0.81 1 U: 0.81 | 3–8j 3 U: 0.65 3 U: 0.69 4 U:0.72 | |||
Gardner et al., Australia [33] | 18–25 years old: Mean age (SD): 21 (2.21) Women: 48% Living with family: 72% | Observational study (n = 159) | Serious mental illnesse | AQoL-8D (Australian general population) | 20-item R-UCLA LSc | 52.48 (12.94) U: 0.42 (0.21) | 50–64c: 52.48 U: 0.42 | |||||
Mountain et al., UK [39] | ≥ 65 years mean age (SD): 72 (65.92) Community living Women: 68% Normal cognition Living alone 55% | RCT involving weekly group sessions Intervention (n = 145) Control (n = 143) | No reported health conditions | EQ-5D-3L (UK general population) | 11-item De Jong Gierveld Loneliness Scale j | Control Baseline: 4.6 (3.6) U: 0.77 (0.24) 6 months 4.1 (3.4) U: 0.76 (0.23) 24 months: 4.8 (3.6) U: 0.71 (0.28) | Intervention Baseline: 4.1 (3.5) U: 0.73 (0.25) 6 months: 3.5 (3.2) U: 0.71 (0.25) 24 months 3.7 (3.4) U: 0.73(0.24) | 3–8 j 4.1 m U: 0.73 4.6 U: 0.77 3.5 U: 0.71 4.1 U: 0.76 3.7 U: 0.73 4.8 U: 0.71 | ||||
Maxwell et al., Canada and USA [44] | ≥ 65 years mean age (SD): 81 (8.4) Home care clients; Women: 72% Widowed 54% Not lonely 77% Self-rated health: Good/Excellent 69% | Cross-sectional design (n = 514) | More than 3 chronic diseases#: 75.3% | HUI2 (Canadian adult population) | Self-reported loneliness status (Yes/No) | NR U: 0.49 (0.18) | No: U: 0.50 | Yes: U: 0.46 | ||||
Action et al., UK [37] | Mean age (SD): 75 (16.21) All Home dwelling | RCT to examine the effect of a home visit–based visual rehabilitation intervention (n = 67) | Sight loss causing difficulties in carrying out daily tasks | EQ-5D-5L (UK general population) | 20-item UCLA LSn | Control Baseline: 10.47 (13.81) U: 0.60 (0.3) 6-months: 12.81 (14.71) U: 0.58 (0.29) | Intervention: Baseline: 13.14 (13.34) U: 0.51 (0.31) 6-months: 14.51 (15.19) U: 0.52 (0.34) | |||||
Packer et al., Australia [35] | Living with diabetes mean age (SD): 60 (11.0) Women: 48% Number of health conditionsk: 2 (1.1) Living with any chronic condition mean age (SD): 70 (10.5) Women: 66% number of health conditions: 2.6 (1.3) | Quasi-ongoexperimental design to investigate the impact of generic and diabetes-specific self-management programmes (n = 485) | Living with diabetes (n = 222) living with any chronic condition (n = 236) | AQoL-8D (Australian general population) | R-UCLA LS 3 itemo Single question (SQ) with four responsesp | Living with diabetes: R-UCLA: 4.02 (1.6) U: 0.73 (0.2) Living with any chronic condition R-UCLA: 4.64 (1.7) U: 0.48 (0.2) Living with diabetes: SQ: 3.24 (0.7) U: 0.48 (0.2) Living with any chronic condition SQ: 3.49 (0.7) U: 0.73 (0.2) | ||||||
Sarant et al., Australia [36] | Mean age (SD) 72 (6.8) | Interventional study investigating the impact of cochlear implants (n = 20) | With severe–profound hearing loss [49] | HUI3 (Not stated) | 11-item De Jong Gierveld Loneliness Scale j | Baseline: 2.64 U:0.56 18-months: 1.39 U:0.67 | 0–2 2.64 U:0.56 1.39 U:0.67 | |||||
Weiss et al., Netherlands [43] | Median age: 60 years; IQR (48.3, 68.0) 77% living alone Low socioeconomic status | RCT to examine the effect of the positive psychology intervention ‘Happiness Route’ [HR] (n = 58) compared to ‘Customised care’ [CC] (n = 50) | Severely lonely High level of comorbidity (median health conditions = 3) | EQ-5D (Dutch population) | 11-item De Jong Gierveld Loneliness Scale j | Control Baseline 9.41 (0.29) U: 0.46 (0.05) 3 months 9.43 (0.39) U: 0.54 (0.06) 9 months 8.85 (0.52) U: 0.5 (0.06) | Intervention Baseline 9.41 (0.29) U: 0.46 (0.05) 3 months 9.43 (0.39) U: 0.54 (0.06) 9 months 8.85 (0.52) U: 0.5 (0.06) | 8–11 j 9.41 m U: 0.46 9.43 U: 0.54 8.85 U: 0.5 9.41 U: 0.46 9.43 U: 0.54 8.85 U: 0.5 | ||||
Marianne Harris et al., Canada [45] | ≥ 35 Mean age: 53 years (8.3) | Cross-sectional study (n = 856) | Diagnosed with HIV for atleast a year | ED-5D-5L (Not stated) | Study specific single questionf | NR U: 0.70 (0.19)g | No: U:0.88 | Yes U:0.70 | ||||
Weng Yew et al., Singapore [41] | Mean age: 54.3 years (16.8) Women: 56.2% Community-dwelling adults | Cross-sectional study (n = 1510) | Skin diseases | EQ-5D-5L | R-UCLA LS 3 itemo | Having a skin disease 3.5 (1.2) U: 0.89 (0.18) Not having a skin disease 3.3 (0.8) U: 0.95 (0.12) | 3–5 3.5 U: 0.89 3.3 U: 0.95 |
Author, Country | Population characteristics | Study design (sample size) | Reported health conditions | Utility instrument (tariff used) | Social isolation measure | Overall population Overall social isolation score (SD) Mean utility score (SD) | Mean Utility scores (U) for those ‘not socially isolated’, ‘socially isolated’ and by levels of social isolation | |
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Yap et al., France [40] | ≥ 65 years mean age (SD): 75 (6.4) living in the community Living alone 33% Women: 94% | RCT to explore the effects of Rhythm-centred music making on HRQoL (n = 54) | More than 3 co-morbidities: 80% | EQ-5D-5L (Singapore general population) | The Lubben Social Network Scale 6-itema | Intervention T1: 18.50 (7.5,23)b U:0.81 (0.67, 0.94) T2: 12.50 (8.5,18.5) U:0.94 (0.72, 1.00) T3: 12.00 (8,16) U:0.87 (0.69, 0.88) | Control T1: 10.00 (4,14) U:0.63 (0.28, 0.74) T2: 12.00 (6, 14) U:0.60 (0.35, 0.86) T3: 11 (6, 17) U:0.63 (0.39, 0.74) | Not socially isolated (greater than 12) 18.50, U:0.81 12.50, U:0.94 Socially isolated (less than 12) 12.00, U:0.87 11.00, U:0.63 12.00, U:0.60 11.00, U:0.63 |
Weng Yew et al., Singapore [41] | Mean age: 54.3 years (16.8) Women: 56.2% Community-dwelling adults | Cross-sectional study (n = 1510) | Skin diseases | EQ-5D-5L | The Lubben Social Network Scale 6-itema | Having a skin disease 15.9 (6.4) U: 0.89 (0.18) Not having a skin disease 16.6 (5.9) U: 0.95 (0.12) | Not socially isolated (greater than 12) 15.9, U:0.89 16.6, U:5.9 | |
Nikmat et al., Malaysia [50] | Patients aged 60–89 years mean age (SD) 69 (6.97) living in community single/separated 42%; healthy 74% nursing homes mean age (SD): 72 (7.66) single/separated: 87%; healthy 60% | Cross-sectional design community (n = 19) nursing home (n = 30) | All having dementia | AQoL-8D (Australian general population) | Friendship Scalec | Community: 15.11 (3.63) U:0.43 (0.18) | Nursing Home: 10.80 (3.68) U:0.30 (0.20) | 15.11-, U:0.43 Very socially isolated: [0–11] 10.80, U:0.30 |
Jansons et al., Australia [34] | ≥ 65 years mean age (SD) Home-based programme: Mean age (SD): 66 (13) Women: 75% Married 61% Gym-based programme Mean age (SD): 68 (11) Women: 54% Married 78% | Interventional study in adults with chronic health conditions such as cancer or diabetes: Home-based programme with telephone support (n = 51) Gym-based exercise programme (n = 54) | Multiple co-morbidities; poor or declining mobility; physical de-conditioning; or a combination of these problems | EQ-5D-3L (UK general population) | Friendship Scalec | Homed Baseline: 19.2 (3.9) U:0.67 (0.21) 3-months 19.0 (4.4) U:0.65 (0.22) 6-months 19.8 (4.1) U:0.67 (0.25) 9-months 19.1 (4.5) U:0.66 90.22) 12-months 17.1 (4.4) U:0.68 (0.22) | Gym Baseline: 19.2 (4.2) U:0.63 (0.26) 3-months 19.2 (4.5) U:0.59 (0.28) 6-months 19.7 (3.4) U:0.67 (0.25) 9-months 20.0 (3.9) U:0.66 (0.23) 12-months 17.5 (4.2) U:0.67 (0.25) | Socially connected d 19.2, U:0.67 19.0, U:0.65 19.8, U:0.67 19.1, U:0.66 19.2, U:0.63 19.2, U:0.59 19.7, U:0.67 20.0, U:0.66 Some social support: 17.1, U:0.68 17.5, U:0.67 |
Hawton et al., United Kingdom [38] | Community living > 50 years of age, at risk of social isolation (n = 232): mean age (SD): 72 (11.8) living alone: 49.6% socially isolated (n = 94): mean age (SD): 69.7 (12.0) living alone: 38.3% severely socially isolated (n = 67): mean age (SD): 69.8 (12.1) living alone: 50.7 | Cross-Sectional Study (n = 393) | At risk of social isolation number of physical co-morbidities 2.0 (1.3) clinically depressed: 37.6% socially isolated: number of physical co-morbidities: 1.6 (1.3) clinically depressed: 34.4% severely socially number of physical co-morbidities 2.1 (1.3) clinically depressed: 65.2% | EQ-5D-3L SF-6D (UK general population) | Social Health Batterye | At risk EQ-5D: 0.65 SF-6D: 0.67 Socially Isolated EQ-5D: 0.69 SF-6D: 0.67 Severely socially isolated EQ-5D: 0.50 (0.32) SF-6D: 0.59 (0.12) | ||
Gardner et al., Australia [33] | 18–25 years old Mean age (SD): 21 (2.21) Women: 48% Living with family: 72% | Exploratory observational study (n = 159) | Serious mental illnessf | AQoL-8D (Australian general population) | The Social Inclusion Scaleg | Socially isolated: 13.41 (3.83) U:0.42 (0.21) | ||
Sarant et al., Australia [36] | Mean age (SD) 72 (6.8) | Interventional study investigating the impact of cochlear implants (n = 20) | with severe–profound hearing loss | HUI3 (Not stated) | The Lubben Social Network Scale-10 item revised h | Baseline: 45.36, U:0.56 18 months: 44.77, U:0.67 |