Effectiveness of Cognitive Interventions for Community-Dwelling Older Adults Living Alone: A Systematic Review and Meta-Analysis

OBJECTIVES: To evaluate the effectiveness of cognitive interventions in enhancing the cognitive function of community-dwelling older adults living alone. METHODS: Five databases were systematically searched for articles published until December 2024. The search identified three randomized controlled trials (RCTs) and four non-RCTs, including case - control studies and quasi-experimental studies, with sample sizes ranging from 20 to 78. After risk of bias was assessed, data were synthesized using a random-effects model. RESULTS: Interventions such as robotic assistance, reminiscence therapy, animal-assisted therapy, creative therapies, and multicomponent programs significantly improved cognitive function (mean difference [MD] = 2.85 in MMSE), reduced depression (standardized MD = -0.85), and mitigated loneliness (MD = -10.13 in UCLA-LS). High heterogeneity was observed, attributable to diverse protocols, participant characteristics, and study designs. Attrition and confounding biases were also identified. CONCLUSIONS: Cognitive interventions can improve cognitive and psychosocial outcomes in community-dwelling older adults living alone. However, further research is required to confirm these findings. CLINICAL IMPLICATIONS: Socially interactive cognitive interventions are a promising strategy for improving the cognitive and mental health of community-dwelling older adults living alone. Clinicians should implement these accessible interventions to improve the population's quality of life and support their independent living.