Telephone-delivered interventions for loneliness and depression in older adults: A rapid review of randomized clinical trials

ABSTRACT

Loneliness and depression impose significant health burdens on older adults, particularly those who are homebound or living in rural areas. While remote care has broadened access to healthcare services, it has also exposed equity gaps in which app and video-centered platforms often marginalize older adults with low digital literacy. As a resolution, telephone-delivery might be helpful to bridge this gap. This rapid review examines randomized clinical trials (RCTs) to examine whether telephone-delivered interventions reduce loneliness and/or depression in older adults and to identify which therapeutic contents produce consistent clinical benefits. A rapid review was conducted in line with updated Cochrane guidance for rapid reviews of effectiveness and PsycINFO, Medline, and CINAHL search, with criteria including RCTs of community-dwelling adults ≥ 60 years, telephone-delivered interventions, and validated loneliness or depression outcomes. Among 79 records, 11 RCTs met the criteria, of which 3 RCTs compared telephone with nontelephone-delivered interventions and 8 compared different telephone-delivered interventions. Most trials showed significant sustained improvement. Additionally, manualized protocols with supervision and outcome monitoring clearly outperformed the nonspecific support. The type of provider was also a key factor. Protocolized layperson-delivered programs reduced loneliness, whereas depression, a more severe condition, showed more pronounced improvements when a more structured or algorithm-guided care was delivered by clinicians or nurses. In sum, telephone-delivered interventions promote health equity by offering essential mental healthcare to digitally excluded older adults. The clinical benefits may be amplified when those calls deliver structured and manualized therapy under appropriate supervision.