Podcast: Video calls for reducing social isolation and loneliness in older people

The response to the COVID-19 pandemic has included restrictions on some people’s movement, to try to protect them from the virus. This isolation may have adverse effects on mental health and, in May 2020, we published a rapid review of the effects of using video calls to ease this among older people. We asked the lead reviewer, Chris Noone from the National University of Ireland in Galway to describe the evidence that they found.

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Monaz: Hello, I'm Monaz Mehta, editor in the Cochrane Editorial and Methods department. The response to the COVID-19 pandemic has included restrictions on some people’s movement, to try to protect them from the virus. This isolation may have adverse effects on mental health and, in May 2020, we published a rapid review of the effects of using video calls to ease this among older people. We asked the lead reviewer, Chris Noone from the National University of Ireland in Galway to describe the evidence that they found.

Chris: Movement and socialising restrictions that have been put in place in some countries have been stricter for those over a certain age or those living in nursing homes. One unfortunate consequence of these actions is that these people in particular may feel lonely and isolated, which may lead to poor mental and physical health.
We wanted to investigate, therefore, if older people who used video calls felt less lonely than those who did not; because video calls may be a good alternative to visiting in person and we hoped to find out if using smartphones, tablets or computers would help older people keep in touch with family and friends. We were also curious about whether video calls affected symptoms of depression or quality of life.
We looked for studies that recruited people aged 65 or above and randomly assigned them to either use video calls, another method of keeping in touch, or some other form of usual care. We found three eligible trials, all done by the same research team in Taiwan, involving just over 200 older people in total. All three trials took place in nursing homes and compared the addition of video calls to usual care versus usual care alone. They were published between 2010 and 2020, but none were done during the current COVID-19 pandemic.
Unfortunately, our confidence in the evidence base is low. This is because there were so few studies, with only a small number of participants, and each study either used unreliable methods or did not fully describe the methods that were used. Another major limitation is that some of the participants may not have actually been feeling lonely or socially isolated at the start of the studies. Also, when thinking about COVID-19, there is an additional challenge because the included studies tested what happened when video calls were added to normal contact opportunities, while, with the prevention of such opportunities due to COVID-19, the key question now is whether video calls can help when social isolation prevents normal contact. 
In summary, therefore, the current evidence doesn’t allow us to say whether video calls might help to reduce loneliness in older people. Clearly, further studies testing the effectiveness of video calls for loneliness or isolation in older adults are needed, and these studies should target older adults across a range of settings who are demonstrably lonely, socially isolated, or both. In this way, we could find out whether video call interventions might prevent or, at least, ease these problems.”

Monaz: If you would like to find out more about the evidence in the current review or watch for updates if new studies become available, particularly in the context of the pandemic control measures for COVID-19, it’s free to view online. Just go to Cochrane Library dot com and search 'video calls and older people',

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