{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:39:31Z","timestamp":1793813971803,"version":"4.6.1"},"reference-count":52,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008667","name":"SENSHIN Medical Research Foundation","doi-asserted-by":"publisher","award":["Overseas Study grant"],"award-info":[{"award-number":["Overseas Study grant"]}],"id":[{"id":"10.13039\/501100008667","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Loneliness is a major psychological challenge in older adulthood, contributing to increased risks of depression, anxiety, and mortality. Conversational agents \u2013 technologies that interact with users via natural language \u2013 have emerged as potential tools to support psychological well-being in later life. This systematic review and meta-analysis evaluated the effects of autonomous conversational agents, including robotic and nonrobotic systems, on loneliness, as well as social isolation, depression, and anxiety in older people without cognitive impairment. Seventeen studies with pre\u2013post intervention data were included. Nine used physically embodied robots and eight employed nonrobotic agents, such as personal voice assistants, chatbots, or screen-based embodied agents. Due to the limited number of high-quality comparison studies, all meta-analyses were based on within-group pre\u2013post comparisons. Meta-analytic results showed mild to moderate improvements in loneliness (standardized mean changes using change score [SMCC]\u00a0=\u00a00.350, 95% confidence interval [CI]: 0.180\u20130.520) and depression (SMCC\u00a0=\u00a00.464, 95% CI: 0.327\u20130.602), with no study reporting symptom worsening. No study included validated measures of social isolation, and only one assessed anxiety. These findings indicate that conversational agents may offer scalable support for older adults\u2019 mental health, with potential especially for reducing loneliness and depression. Nonetheless, methodological limitations, including lack of blinded outcome assessment, inconsistent reporting, and heterogeneous intervention designs, underscore the need for more rigorous research. Advances in large language models may further enhance the responsiveness and relevance of these technologies for supporting psychological well-being in aging populations.<\/jats:p>","DOI":"10.1017\/s0033291725103073","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T09:00:40Z","timestamp":1768899640000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":12,"title":["Autonomous conversational agents for loneliness, social isolation, depression, and anxiety in older people without cognitive impairment: Systematic review and meta-analysis"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9350-3162","authenticated-orcid":false,"given":"Yuto","family":"Satake","sequence":"first","affiliation":[{"name":"University College London"},{"name":"The University of Osaka Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4490-9219","authenticated-orcid":false,"given":"Harry","family":"Costello","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4367-5011","authenticated-orcid":false,"given":"Nimesh","family":"Naran","sequence":"additional","affiliation":[{"name":"North London NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-8220","authenticated-orcid":false,"given":"Daiki","family":"Ishimaru","sequence":"additional","affiliation":[{"name":"The University of Osaka Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Ikeda","sequence":"additional","affiliation":[{"name":"The University of Osaka Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3071-2338","authenticated-orcid":false,"given":"Robert","family":"Howard","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"S0033291725103073_r17","unstructured":"Japan Cabinet Office. 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