{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:03:30Z","timestamp":1790381010955,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Caring Sciences"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Loneliness, distinct from social isolation, is a subjective sense of social disconnection exacerbating a public health crisis among older adults. Affecting ~33% of community\u2010dwelling individuals aged 50\u201380\u2009years post\u2010COVID\u201019, it rivals smoking in mortality risk and drives cognitive, cardiovascular, and mental health declines. This review synthesises evidence to inform clinical strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A critical review of per\u2010reviewed meta\u2010analyses, RCTs, and prospective cohorts literature (2019\u20132025) was conducted for adults aged 50\u2009years and above. Studies were selected using validated loneliness or social isolation measures, with quality appraised via AMSTAR\u20102, Cochrane RoB 2, and Newcastle\u2010Ottawa Scale; 34 studies met eligibility criteria from an initial yield of 1,847 records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prevalence of loneliness stands at 29% isolation by 2024, highest among those with poor health (53%\u201375%), unemployment (52%), solitary living, and ages 50\u201364. Loneliness elevates all\u2010cause mortality (32%), dementia (50%\u201359%), cardiovascular events (29%\u201332%), depression (40%), and anxiety (35%). Mechanisms include increased inflammation (\u2191CRP, IL\u20106), HPA dysregulation, immune compromise, hippocampal atrophy, and behavioural lapses. Interventions like CBT\/reminiscence therapy, multicomponent programs, animal therapy, exercise, and digital platforms have been shown to reduce loneliness, though primary care implementation lags due to screening\/referral barriers. Tools such as the UCLA Loneliness Scale enable feasible assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Loneliness as a geriatric syndrome demands mandated screening, provider education, and reimbursement reforms. Coordinated healthcare\u2010community efforts could avert substantial morbidity\/mortality, addressing gaps in long\u2010term outcomes and cost\u2010effectiveness research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scs.70292","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:42:46Z","timestamp":1782819766000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Silent Crisis: Loneliness in Older Adults\u2014A Critical Review of Impacts, Strategies and Path Forward"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3022-8690","authenticated-orcid":false,"given":"Hanif","family":"Abdul Rahman","sequence":"first","affiliation":[{"name":"PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam  Brunei Darussalam"},{"name":"Saw Swee Hock School of Public Health, National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurrabiatul Haziqah","family":"Zahari","sequence":"additional","affiliation":[{"name":"PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam  Brunei Darussalam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System","author":"Sciences NA of, Medicine, Behavioral D of, Sciences S, Division M, Behavioral B on","year":"2020"},{"issue":"1","key":"e_1_2_14_3_1","first-page":"59","article-title":"Social Isolation and Loneliness in Old Age: Exploring Their Role in Mental and Physical Health","volume":"32","author":"Tragantzopoulou 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