A type of talk therapy called behavioral activation, which researchers adapted for phone delivery to older adults socially isolated by the COVID-19 pandemic, showed benefits for mitigating loneliness and depression. Researchers published preliminary results from their pilot study online in PLOS Medicine.

“Along with many researchers working in the field of mental health, we were keen to use our existing research expertise and research capacity to help mitigate the impact of the COVID-19 pandemic,” wrote the UK-based team. “We therefore adapted our previous and ongoing work program in early 2020 to answer the following question: ‘Can we prevent or ameliorate depression and loneliness in older people with long-term conditions during isolation?’”

The pilot trial randomized 96 older adults with long-term health conditions to 1 of 2 interventions over an 8-week period: brief phone-based behavioral activation, which aimed to connect people to sources of positive reinforcement through meaningful daily routines and social contact, or a usual care control intervention.

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According to the study, older adults who received the phone intervention appreciated the contact and found it to be helpful for maintaining daily routines. Preliminary evidence also suggested improved mental health and a strong indication of decreased rates of loneliness with the phone intervention.

“Although underpowered to test effectiveness, the between-group comparisons using confidence intervals included benefit for behavioral activation in mitigating levels of depression at 3 months,” researchers wrote. “For our measure of loneliness, there was good evidence of benefit and was unlikely to be a chance finding.”

The pilot trial also revealed older adults’ preference for phone contact over video calling as well as greater interest among older adults with depressive symptoms above a certain threshold.

Encouraged by the findings, researchers are currently recruiting more than 600 older adults for a follow-up trial at multiple sites in England and Wales.

“The preliminary results are in line with potential benefit for this intervention in mitigating loneliness at 3 months. We will now test the short- and long-term clinical and cost-effectiveness,” researchers wrote. “This evidence may prove to be useful in improving the mental health of populations during the time of COVID-19 and also in mitigating depression and loneliness in socially isolated at-risk populations after the pandemic has passed.”

References

Gilbody S, Littlewood E, McMillan D, et al. Behavioural activation to prevent depression and loneliness among socially isolated older people with long-term conditions: The BASIL COVID-19 pilot randomised controlled trial. PLoS Med. Published online October 12, 2021. doi: 10.1371/journal.pmed.1003779

Ground-breaking trial prevents loneliness among older people during Covid pandemic. News release. University of York; October 12, 2021. Accessed October 22, 2021.