Loneliness Among Older Adults in COVID-19: A Living Systematic Review of Changes in Loneliness from Pre-COVID-19, Association with Mental Health Outcomes, and Effects of Interventions

There will be serious loneliness and mental health implications from COVID-19 that extend beyond the pandemic for many people, especially older adults. Addressing these needs requires understanding their nature and extent and evidence on effectiveness of interventions that may be rapidly employed to prevent or address loneliness and mental health concerns. Studies from COVID-19 are published rapidly, but many are of dubious quality. Thus, curation of this growing evidence base is urgently needed to provide practitioners and policy makers with clear, coherent evidence synthesis. Living systematic reviews are systematic reviews that are continually updated and provide ongoing access to results via online publication. They are logistically challenging, but provide value beyond conventional systematic reviews in situations where (1) important decisions need to be made; (2) uncertainty in existing evidence poses a barrier to decision-making; and (3) new evidence is emerging rapidly. Such a review is urgently needed to guide mental health care during and following COVID-19. Our research team has expertise in high-impact evidence synthesis research (). Our protocol has been made public on the Open Science Framework (). We have already sorted through over 190,000 citations from 10 databases, including two Chinese-language databases, reviewed over 69,000 unique citations, and identified over 260 eligible studies, including studies on older adults. We have published initial evidence online from general populations (). We are working closely with Canadian government personnel to inform mental health strategy for older adults. Important evidence will be published in the months to come. It is crucial to maintain funding for this important project to incorporate the higher quality evidence that is beginning to be made available.