Cambridge Public Health, University of Cambridge, Cambridge, UK.
School of Clinical Medicine, University of Cambridge Medical Library, Cambridge, UK.
Health Soc Care Community. 2022 Jan;30(1):27-57. doi: 10.1111/hsc.13413. Epub 2021 May 14.
Mental health concerns in older adults are common, with increasing age-related risks to physical health, mobility and social isolation. Community-based approaches are a key focus of public health strategy in the UK, and may reduce the impact of these risks, protecting mental health and promoting wellbeing. We conducted a review of UK community-based interventions to understand the types of intervention studied and mental health/wellbeing impacts reported.
We conducted a scoping review of the literature, systematically searching six electronic databases (2000-2020) to identify academic studies of any non-clinical community intervention to improve mental health or wellbeing outcomes for older adults. Data were extracted, grouped by population targeted, intervention type, and outcomes reported, and synthesised according to a framework categorising community actions targeting older adults.
In total, 1,131 full-text articles were assessed for eligibility and 54 included in the final synthesis. Example interventions included: link workers; telephone helplines; befriending; digital support services; group social activities. These were grouped into: connector services, gateway services/approaches, direct interventions and systems approaches. These interventions aimed to address key risk factors: loneliness, social isolation, being a caregiver and living with long-term health conditions. Outcome measurement varied greatly, confounding strong evidence in favour of particular intervention types.
The literature is wide-ranging in focus and methodology. Greater specificity and consistency in outcome measurement are required to evidence effectiveness - no single category of intervention yet stands out as 'promising'. More robust evidence on the active components of interventions to promote older adult's mental health is required.
老年人的心理健康问题很常见,随着年龄的增长,他们面临着越来越多与身体健康、行动能力和社会隔离相关的风险。基于社区的方法是英国公共卫生战略的重点,它可能会降低这些风险的影响,保护老年人的心理健康并促进其幸福感。我们对英国基于社区的干预措施进行了综述,以了解所研究的干预措施类型和报告的心理健康/幸福感影响。
我们对文献进行了范围界定审查,系统地搜索了六个电子数据库(2000-2020 年),以确定任何非临床社区干预措施的学术研究,这些研究旨在改善老年人的心理健康或幸福感结果。提取数据,按目标人群、干预类型和报告的结果进行分组,并根据针对老年人的社区行动分类框架进行综合分析。
共有 1131 篇全文文章进行了资格评估,最终纳入了 54 篇综述。示例干预措施包括:联络工作者;电话热线;交友;数字支持服务;团体社交活动。这些干预措施被分为:连接服务、入口服务/方法、直接干预和系统方法。这些干预措施旨在解决关键的风险因素:孤独、社会隔离、作为照顾者和长期健康状况。测量结果变化很大,这使得特定干预类型的有力证据难以获得。需要更具体和一致的结果测量方法来证明有效性-没有一种干预类别可以脱颖而出。需要更多关于促进老年人心理健康的干预措施的有效成分的更有力的证据。