Prevalence and determinants of social isolation and loneliness among the elderly in India: A systematic review
Neha Muralidharan, Rajeswaran Thiagesan, Vijayaprasad GopichandranBackground and objectives
The population of older persons is increasing in India, with a projection of 230 million by 2036. With the increasing population of older persons, the prevalence of social isolation and loneliness is also increasing. The objective of the review was to assess the prevalence of social isolation and loneliness among older persons in India and to identify their risk factors.
Methods
The protocol for this systematic review was registered with PROSPERO (CRD420251172242). We included studies that reported the prevalence of social isolation and loneliness among older persons above 60 years of age in India. Data sources included PubMed, SCOPUS, CINAHL, and EBSCO databases. Studies were screened and selected using Rayyan software, and data were extracted and assessed for risk of bias using the Newcastle Ottawa scale. A meta-analysis was attempted, but the I 2 was 99%, indicating high heterogeneity, and so a narrative synthesis was performed. The heterogeneity was due to different scales and different cut-off points.
Results
Out of 894 identified papers, 20 studies were included in the final review. The prevalence of loneliness obtained from 11 studies ranged from 3.8 to 66.4%, while social isolation obtained from 4 studies ranged from 3.6 to 86.4%. Key risk factors identified from 12 studies included increasing age, poor socio-economic status, poor physical health, mental health, and various social factors such as marital status, living conditions, strained relationships, elder abuse, and disengagement from social activities.
Interpretations and conclusions
The review highlights a significant burden of social isolation and loneliness among the elderly in India, influenced by demographic, health, and social factors. A pooled estimate of prevalence was not feasible due to the heterogeneity of studies. Future research should focus on population-based assessment using standard, validated scales to better understand the magnitude of the problem.