Effectiveness of digital health interventions in reducing loneliness among older adults: a systematic review and meta-analysis

BACKGROUND: Loneliness affects 12% of older adults globally, with concerns exacerbated by the COVID-19 pandemic. While digital health interventions (DHIs) show promise, evidence of their effectiveness remains mixed. METHODOLOGY: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted in the PubMed, Cochrane, Web of Science and Embase databases (2010-25). Inclusion criteria were adults aged 60 years, with loneliness as the primary or secondary outcome. Study quality was assessed using GRADE and Cochrane risk of bias tools. Subgroup analyses explored intervention type, measurement scales, national development level, pandemic timing and some secondary outcomes. RESULTS: Seventeen studies (n = 2423) showed DHIs significantly reduced loneliness scores (standardized mean difference [SMD] = -0.39, 95% CI -0.77 to -0.01). Subgroup analyses revealed significant reductions for social cognitive training (SMD = -0.82, 95% CI -1.47 to -0.16). Greater effectiveness was observed in developed countries (SMD = -0.30, 95% CI: -0.51 to -0.09) and during the pandemic period (SMD = -0.54, 95% CI: -1.03 to -0.06). DHIs also improved mental health (SMD = 0.98, 95% CI: 0.12 to 1.84) and marginally reduced depressive symptoms (SMD = -0.73, 95% CI: -1.45 to 0.00). CONCLUSION: DHIs show promise in reducing loneliness scores among older adults, particularly through cognitive-focused interventions in supportive digital environments. However, the overall effect is modest and highly heterogeneous, with benefits that appear context-dependent and short-lived. Future research should prioritise standardised measurement, diverse populations and long-term follow-up to optimise DHI design.