Social capital interventions targeting older people and their impact on health: a systematic review

• Published in: Journal of epidemiology and community health (1979) Vol. 71; no. 7; pp. 663 - 672
• Main Authors: Coll-Planas, Laura, Nyqvist, Fredrica, Puig, Teresa, Urrútia, Gerard, Solà, Ivan, Monteserín, Rosa
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.07.2017; BMJ Publishing Group LTD
• Subjects: Aged; Alzheimer's disease; Bias; Canada; Caregivers; Clinical trials; Dementia; Design; Health disparities; Humans; Intervention; Loneliness; Mental health; Middle Aged; Mood; Mortality; Nursing homes; Older people; Prospero protein; Public health; Quality of Life; Review; Reviews; Social behavior; Social Capital; Social interactions; Social networks; Social Participation; Social research; Social Support; Systematic review; AGEING; RANDOMISED TRIALS; SYSTEMATIC REVIEWS; SOCIAL CAPITAL; HEALTH IMPACT ASSESSMENT
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech-2016-208131

BackgroundObservational studies show that social capital is a protective health factor. Therefore, we aim to assess the currently unclear health impact of social capital interventions targeting older adults.MethodsWe conducted a systematic review based on a logic model. Studies published between January 1980 and July 2015 were retrieved from MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Web of Science. We included randomised controlled trials targeting participants over 60 years old and focused on social capital or its components (eg, social support and social participation). The comparison group should not promote social capital. We assessed risk of bias and impact on health outcomes and use of health-related resources applying a procedure from the Canadian Agency for Drugs and Technologies in Health (CADTH) based on vote-counting and standardised decision rules. The review protocol was registered in PROSPERO (reference number CRD42014015362).ResultsWe examined 17 341 abstracts and included 73 papers reporting 36 trials. Trials were clinically and methodologically diverse and reported positive effects in different contexts, populations and interventions across multiple subjective and objective measures. According to sufficiently reported outcomes, social capital interventions showed mixed effects on quality of life, well-being and self-perceived health and were generally ineffective on loneliness, mood and mortality. Eight trials with high quality showed favourable impacts on overall, mental and physical health, mortality and use of health-related resources.ConclusionsOur review highlights the lack of evidence and the diversity among trials, while supporting the potential of social capital interventions to reach comprehensive health effects in older adults.