Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Dec 22, 2015; 5(4): 432-438
Published online Dec 22, 2015. doi: 10.5498/wjp.v5.i4.432
Impact of social isolation on behavioral health in elderly: Systematic review
Hanbyul Choi, Michael R Irwin, Hyong Jin Cho
Hanbyul Choi, St. George’s University School of Medicine, Grenada, West Indies, the North American Correspondent, Great River, NY 11739, United States
Michael R Irwin, Hyong Jin Cho, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA 90095, United States
Author contributions: Choi H and Cho HJ developed the study concept and design; Choi H acquired the data; Choi H and Cho HJ analyzed and interpreted the data; Choi H, Irwin MR and Cho HJ drafted and critically reviewed the manuscript.
Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hyong Jin Cho, MD, PhD, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California-Los Angeles, 300 UCLA Medical Plaza, Suite 3140, Los Angeles, CA 90095, United States. hjcho@mednet.ucla.edu
Telephone: +1-310-8250227 Fax: +1-310-8256483
Received: June 12, 2015
Peer-review started: June 14, 2015
First decision: August 25, 2015
Revised: September 23, 2015
Accepted: November 10, 2015
Article in press: November 11, 2015
Published online: December 22, 2015
Processing time: 189 Days and 11 Hours
Abstract

AIM: To examine and compare the effects of subjective and objective social isolation on behavioral health in elderly adults.

METHODS: A systematic search of PubMed was performed for original research articles from peer-reviewed journals examining one of the following topics: “Social isolation and sleep disturbance”, “social isolation and depression”, or “social isolation and fatigue in older adults”. Studies were selected following the criteria established based on the aim of this review. Data were extracted from the articles by two independent reviewers. Due to the heterogeneity in study designs and outcome measures of the included studies, qualitative and narrative analyses were conducted.

RESULTS: The set criteria were used to select a total of 16 studies for the review. Of the 16, 13 were cross-sectional studies. The characteristics of study populations were identified as follows. A total of 12 studies randomly selected subjects irrespective of pre-existing health conditions. Consequently, an unspecified number of the study subjects had chronic diseases in the studies compared. In addition, cultural and ethnic backgrounds of studies in this review were diverse, and included subjects living in North America, South America, Asia, Europe, and Oceania. Both subjective and objective types of social isolation increased behavioral symptoms, such as sleep disturbance, depressive symptoms, and fatigue in older adults. Furthermore, a few recent studies reported stronger effects of subjective social isolation than objective social isolation on sleep disturbance and depressive symptoms.

CONCLUSION: Social isolation affects behavioral health in older adults. Compared to the objective social isolation, subjective social isolation contributes more significantly to sleep disturbance and depression.

Keywords: Older adults; Depression; Subjective social isolation; Objective social isolation; Sleep disturbance; Fatigue; Systematic review

Core tip: Older adults often experience social isolation which may have a profound negative effect on their behavioral health. However, to date, no systematic review has addressed this issue. Furthermore, few studies have distinguished the effects of subjective vs objective social isolation on behavioral health in this population. The findings of this systematic review suggest that social isolation in late life may indeed increase behavioral symptoms such as sleep disturbance, depression, and fatigue. Moreover, the effects of subjective social isolation, compared to objective social isolation, may contribute more significantly to sleep disturbance and depressive symptoms.