Digital health interventions in reducing loneliness and improving mental health in older adults - a literature review
DOI:
https://doi.org/10.12775/JEHS.2025.82.60434Keywords
loneliness, Aged, Digital health, Virtual Reality (VR) Therapy, chatbot, companion robots, mHealth, videoconferencingAbstract
Introduction: Loneliness remains a concerning health issue, especially among the older population. It leads to numerous negative psychological and physiological negative health outcomes. Digital health interventions have presented themselves as promising strategies for mitigating loneliness and improving mental health in this demographic group.
Aim of the study: This review aims to evaluate existing literature on select digital health interventions in mitigating loneliness and improving mental well-being in the older population. We aimed to present strengths, limitations and obstacles to adoption of these types of interventions, while providing insights into areas of research which could be more thoroughly explored.
Materials and methods: To write this article, databases such as Scopus, PubMed and Google Scholar were searched using the key terms to find relevant information. Studies published between 2009 and 2025 were included.
Conclusions: Digital health interventions, including mHealth apps, virtual reality systems (VR), AI (artificial intelligence) chatbots, companion robots, and video communication platforms have shown potential of mitigating loneliness among older adults. However, the evidence is mixed due to differences in methods of measurement, short duration of follow-up research and obstacles to adoption such as digital literacy, technical barriers and ethical considerations. To fully determine their effectiveness, future studies should implement standardized measurement of outcomes, explore personalized interventions and mitigate the barriers to adoption. Possible risks of overreliance, personal data safety, and discouragement of human relations need to be addressed.
References
1.Luhmann M, Hawkley LC. Age differences in loneliness from late adolescence to oldest old age. Developmental Psychology. 2016;52(6):943-959. doi:https://doi.org/10.1037/dev0000117
2.Courtin E, Knapp M. Social isolation, loneliness and health in old age: A scoping review. Health & Social Care in the Community. 2017;25(3):799-812. doi:https://doi.org/10.1111/hsc.12311
3.Chawla K, Kunonga TP, Stow D, Barker R, Craig D, Hanratty B. Prevalence of loneliness amongst older people in high-income countries: A systematic review and meta-analysis. Aslam MS, ed. PLOS ONE. 2021;16(7):e0255088. doi:https://doi.org/10.1371/journal.pone.0255088
4.Gardiner C, Laud P, Heaton T, Gott M. What is the prevalence of loneliness amongst older people living in residential and nursing care homes? A systematic review and meta-analysis. Age And Ageing. 2020;49(5). doi:https://doi.org/10.1093/ageing/afaa049
5.Schroyen S, Janssen N, Duffner LA, et al. Prevalence of Loneliness in Older Adults: A Scoping Review. Health & Social Care in the Community. 2023;2023:e7726692. doi:https://doi.org/10.1155/2023/7726692
6.Elias SMS. Prevalence of Loneliness, Anxiety, and Depression among Older People Living in Long-Term Care: A Review. INTERNATIONAL JOURNAL OF CARE SCHOLARS. 2018;1(1):39-43. doi:https://doi.org/10.31436/ijcs.v1i1.44
7.Stegen H, Daan Duppen, Perseverence Savieri, et al. Loneliness prevalence of community-dwelling older adults and the impact of the mode of measurement, data collection, and country: A systematic review and meta-analysis. International psychogeriatrics. Published online March 25, 2024:1-15. doi:https://doi.org/10.1017/s1041610224000425
8.Su Y, Rao W, Li M, Caron G, D’Arcy C, Meng X. Prevalence of Loneliness and Social Isolation among Older Adults during the COVID-19 pandemic: a Systematic Review and meta-analysis. International Psychogeriatrics. 2022;35(5):1-13. doi:https://doi.org/10.1017/s1041610222000199
9.Vozikaki M, Papadaki A, Linardakis M, Philalithis A. Loneliness among older European adults: results from the survey of health, aging and retirement in Europe. Journal of Public Health. 2018;26(6):613-624. doi:https://doi.org/10.1007/s10389-018-0916-6
10.Sundström G, Fransson E, Malmberg B, Davey A. Loneliness among older Europeans. European Journal of Ageing. 2009;6(4):267-275. doi:https://doi.org/10.1007/s10433-009-0134-8
11.Cohen-Mansfield J, Hazan H, Lerman Y, Shalom V. Correlates and Predictors of Loneliness in older-adults: a Review of Quantitative Results Informed by Qualitative Insights. International Psychogeriatrics. 2015;28(4):557-576. doi:https://doi.org/10.1017/s1041610215001532
12.Shankar A, McMunn A, Banks J, Steptoe A. Loneliness, social isolation, and behavioral and biological health indicators in older adults. Health Psychology. 2011;30(4):377-385. doi:https://doi.org/10.1037/a0022826
13.Gerst-Emerson K, Jayawardhana J. Loneliness as a Public Health Issue: The Impact of Loneliness on Health Care Utilization Among Older Adults. American Journal of Public Health. 2015;105(5):1013-1019. doi:https://doi.org/10.2105/ajph.2014.302427
14.Huygelier H, Schraepen B, van Ee R, Vanden Abeele V, Gillebert CR. Acceptance of immersive head-mounted virtual reality in older adults. Scientific Reports. 2019;9(1). doi:https://doi.org/10.1038/s41598-019-41200-6
15.Roberts AR, De Schutter B, Franks K, Radina ME. Older Adults’ Experiences with Audiovisual Virtual Reality: Perceived Usefulness and Other Factors Influencing Technology Acceptance. Clinical Gerontologist. 2018;42(1):27-33. doi:https://doi.org/10.1080/07317115.2018.1442380
16.Lin CX, Lee C, Lally D, Coughlin JF. Impact of Virtual Reality (VR) Experience on Older Adults’ Well-Being. Human Aspects of IT for the Aged Population Applications in Health, Assistance, and Entertainment. 2018;10927:89-100. doi:https://doi.org/10.1007/978-3-319-92037-5_8
17.Walden A, Griffith C, Downey P, Feliciano L. IMMERSIVE VIRTUAL REALITY INTERVENTIONS FOR OLDER ADULTS: A SERIES OF META-ANALYSES. Innovation in aging. 2023;7(Supplement_1):875-876. doi:https://doi.org/10.1093/geroni/igad104.2818
18.Ke Z, Wei M, Yang F, et al. The effectiveness of immersive virtual reality on the psychology of older adults: A systematic review and Meta-analysis of randomized controlled trials. General Hospital Psychiatry. 2025;94:86-96. doi:https://doi.org/10.1016/j.genhosppsych.2025.02.024
19.Finnegan D, Campbell S. Tackling Loneliness and Isolation in Older Adults With Virtual Reality: How do We Move Forward? Southern Gerontology Society. 2023;9. doi:https://doi.org/10.1177/23337214231186204
20.Hung L, Mann J, Wallsworth C, et al. Facilitators and Barriers to Using Virtual Reality and its Impact on Social Engagement in Aged Care Settings: A Scoping Review. Gerontology & geriatric medicine. 2023;9:23337214231166355. doi:https://doi.org/10.1177/23337214231166355
21.Seifert A, Schlomann A. The Use of Virtual and Augmented Reality by Older Adults: Potentials and Challenges. Frontiers in Virtual Reality. 2021;2. doi:https://doi.org/10.3389/frvir.2021.639718
22.Skurla MD, Rahman AT, Salcone S, et al. Virtual reality and mental health in older adults: a systematic review. International Psychogeriatrics. 2021;34(2):1-13. doi:https://doi.org/10.1017/s104161022100017x
23.Chou YH, Chia Wei Lin, Lee SH, Ya-Wen Chang Chien, Cheng L. Potential Mobile Health Applications for Improving the Mental Health of the Elderly: A Systematic Review. Clinical Interventions in Aging. 2023;Volume 18:1523-1534. doi:https://doi.org/10.2147/cia.s410396
24.Sen K, Prybutok G, Prybutok V. The use of digital technology for social wellbeing reduces social isolation in older adults: A systematic review. SSM - Population Health. 2022;17(101020):101020. doi:https://doi.org/10.1016/j.ssmph.2021.101020
25.Jarvis MA, Chipps J, Padmanabhanunni A. “This phone saved my life”: Older persons’ experiences and appraisals of an mHealth intervention aimed at addressing loneliness. Journal of Psychology in Africa. 2019;29(2):159-166. doi:https://doi.org/10.1080/14330237.2019.1594650
26.Jansen-Kosterink S, Varenbrink P, Naafs A. The GezelschApp - A Dutch Mobile Application to Reduce Social Isolation and Loneliness. Proceedings of the 4th International Conference on Information and Communication Technologies for Ageing Well and e-Health. 2018;1:142-147. doi:https://doi.org/10.5220/0006732501420147
27.Choi HK, Lee K, Lee SH. Developmental Study on “Smart Silver Care”: A Mobile Application to Alleviate Loneliness in Older Adults within the Community. Healthcare. 2023;11(17):2376. doi:https://doi.org/10.3390/healthcare11172376
28.Tsai HH, Cheng CY, Shieh WY, Chang YC. Effects of a smartphone-based videoconferencing program for older nursing home residents on depression, loneliness, and quality of life: a quasi-experimental study. BMC Geriatrics. 2020;20(1). doi:https://doi.org/10.1186/s12877-020-1426-2
29.Paul M, Maglaras L, Ferrag MA, Almomani I. Digitization of healthcare sector: A study on privacy and security concerns. ICT Express. 2023;9(4):571-588. doi:https://doi.org/10.1016/j.icte.2023.02.007
30.Tangari G, Ikram M, Sentana IWB, Ijaz K, Kaafar MA, Berkovsky S. Analyzing security issues of android mobile health and medical applications. Journal of the American Medical Informatics Association. 2021;28(10):2074-2084. doi:https://doi.org/10.1093/jamia/ocab131
31.Choi HK, Lee SH. Trends and Effectiveness of ICT Interventions for the Elderly to Reduce Loneliness: A Systematic Review. Healthcare. 2021;9(3):293. doi:https://doi.org/10.3390/healthcare9030293
32.Rodríguez-Martínez A, Amezcua-Aguilar T, Cortés-Moreno J, Jiménez-Delgado JJ. Qualitative Analysis of Conversational Chatbots to Alleviate Loneliness in Older Adults as a Strategy for Emotional Health. Healthcare. 2024;12(1):62. doi:https://doi.org/10.3390/healthcare12010062
33.Julian De Freitas, Ahmet Kaan Uğuralp, Zeliha Uğuralp, Stefano Puntoni. AI Companions Reduce Loneliness. SSRN Electronic Journal. Published online January 1, 2024. doi:https://doi.org/10.2139/ssrn.4893097
34.Jones VK, Hanus M, Yan C, Shade MY, Blaskewicz Boron J, Maschieri Bicudo R. Reducing Loneliness Among Aging Adults: The Roles of Personal Voice Assistants and Anthropomorphic Interactions. Frontiers in Public Health. 2021;9. doi:https://doi.org/10.3389/fpubh.2021.750736
35.Valtolina S, Hu L. Charlie: A chatbot to improve the elderly quality of life and to make them more active to fight their sense of loneliness. CHItaly 2021: 14th Biannual Conference of the Italian SIGCHI Chapter. Published online July 11, 2021. doi:https://doi.org/10.1145/3464385.3464726
36.Dosovitsky G, Bunge EL. Bonding With Bot: User Feedback on a Chatbot for Social Isolation. Frontiers in Digital Health. 2021;3:735053. doi:https://doi.org/10.3389/fdgth.2021.735053
37.Brown JEH, Halpern J. AI chatbots cannot replace human interactions in the pursuit of more inclusive mental healthcare. SSM - Mental Health. 2021;1(1):100017. doi:https://doi.org/10.1016/j.ssmmh.2021.100017
38.Abeer Alessa, Al‐Khalifa HS. Towards Designing a ChatGPT Conversational Companion for Elderly People. arXiv (Cornell University). Published online July 5, 2023. doi:https://doi.org/10.1145/3594806.3596572
39.Skjuve M, Følstad A, Fostervold KI, Brandtzaeg PB. My Chatbot Companion - a Study of Human-Chatbot Relationships. International Journal of Human-Computer Studies. 2021;149(1071-5819):102601. doi:https://doi.org/10.1016/j.ijhcs.2021.102601
40.Robinson H, MacDonald B, Kerse N, Broadbent E. The Psychosocial Effects of a Companion Robot: A Randomized Controlled Trial. Journal of the American Medical Directors Association. 2013;14(9):661-667. doi:https://doi.org/10.1016/j.jamda.2013.02.007
41.Moyle W, Cooke M, Beattie E, et al. Exploring the Effect of Companion Robots on Emotional Expression in Older Adults with Dementia: A Pilot Randomized Controlled Trial. Journal of Gerontological Nursing. 2013;39(5):46-53. doi:https://doi.org/10.3928/00989134-20130313-03
42.Yen HY, Chih Wei Huang, Chiu HL, Jin G. The Effect of Social Robots on Depression and Loneliness for Older Residents in Long-Term Care Facilities: A Meta-Analysis of Randomized Controlled Trials. Journal of the American Medical Directors Association. 2024;25(6):104979-104979. doi:https://doi.org/10.1016/j.jamda.2024.02.017
43.Gasteiger N, Loveys K, Law M, Broadbent E. Friends from the Future: A Scoping Review of Research into Robots and Computer Agents to Combat Loneliness in Older People. Clinical Interventions in Aging. 2021;Volume 16:941-971. doi:https://doi.org/10.2147/cia.s282709
44.Pu L, Moyle W, Jones C, Todorovic M. The Effectiveness of Social Robots for Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. The Gerontologist. 2018;59(1):e37-e51. doi:https://doi.org/10.1093/geront/gny046
45.Sharkey A, Sharkey N. Granny and the robots: ethical issues in robot care for the elderly. Ethics and Information Technology. 2012;14(1):27-40. doi:https://doi.org/10.1007/s10676-010-9234-6
46.Berridge C, Zhou Y, Robillard JM, Kaye J. Companion robots to mitigate loneliness among older adults: Perceptions of benefit and possible deception. Frontiers in Psychology. 2023;14. doi:https://doi.org/10.3389/fpsyg.2023.1106633
47.Zamir S, Hennessy CH, Taylor AH, Jones RB. Video-calls to reduce loneliness and social isolation within care environments for older people: an implementation study using collaborative action research. BMC Geriatrics. 2018;18(1). doi:https://doi.org/10.1186/s12877-018-0746-y
48.Zamir S, Hennessy C, Taylor A, Jones R. Intergroup “Skype” Quiz Sessions in Care Homes to Reduce Loneliness and Social Isolation in Older People. Geriatrics. 2020;5(4):90. doi:https://doi.org/10.3390/geriatrics5040090
49.Bonsaksen T, Thygesen H, Leung J, et al. Video-Based Communication and Its Association with Loneliness, Mental Health and Quality of Life among Older People during the COVID-19 Outbreak. International Journal of Environmental Research and Public Health. 2021;18(12):6284. doi:https://doi.org/10.3390/ijerph18126284
50.Noone C, McSharry J, Smalle M, et al. Video calls for reducing social isolation and loneliness in older people: a rapid review. Cochrane Database of Systematic Reviews. 2020;5(5). doi:https://doi.org/10.1002/14651858.cd013632
51.Jin W, Liu Y, Yuan S, Bai R, Li X, Bai Z. The Effectiveness of Technology-Based Interventions for Reducing Loneliness in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Psychology. 2021;12. doi:https://doi.org/10.3389/fpsyg.2021.711030
52.Freedman VA, Hu M, Kasper JD. Changes in older adults’ social contact during the COVID-19 pandemic. The Journals of Gerontology: Series B. Published online September 16, 2021. doi:https://doi.org/10.1093/geronb/gbab166
53.Øverup CS, Lehane CM, Hald GM. The “in it together” digital intervention to treat distress among older adults with sensory loss and their spouses: Study protocol for a randomized controlled trial study. Internet Interventions. 2022;29:100557. doi:https://doi.org/10.1016/j.invent.2022.100557
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Jakub Kołacz, Patrycja Oleś, Marcin Kwiatkowski, Tomasz Koziński, Marta Donderska, Paulina Bochniak, Mateusz Bryła, Zofia Bryła, Monika Spaczyńska-Kwiatkowska, Tomasz Włoch
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 121
Number of citations: 0
