Introduction
The distinct but related experiences of social isolation (the objective lack of social contact with others) and loneliness (a distressing affective state caused by the absence of social contact) can have profound, negative impacts on physical and mental wellbeing across all ages (Leigh-Hunt et al., ), rivaling well-established mortality risks such as smoking, high blood pressure, and obesity (Cacioppo and Cacioppo, ). Whilst social isolation and loneliness (SI/L) occur across the life span, older adults are a population noted to be especially vulnerable to these experiences, along with the associated negative impacts on mental health, physical health, and wellbeing (Anderson and Thayer, ; O'Súilleabháin et al., ; Cudjoe et al., ; World Health Organization, ). Given this vulnerability, developing interventions to ameliorate SI/L in older adults is of clear practical importance.
Interestingly, theater-based interventions have gained traction in recent years as a means of enhancing healthy cognitive aging by providing complex, dynamic, and cognitively demanding tasks (Noice et al., ; Noice and Noice, ). Building upon these findings, this article proposes that theater-based interventions may also provide complex and varied social tasks to older adults, with the potential to reduce SI/L by encouraging frequent and engaging social interactions, strengthening social cognition, and facilitating successful aging.
Prevalence of social isolation and loneliness in older adults and associated risk factors
Predictions from the World Health Organization indicate that the population of older adults (aged 60+) will significantly expand over the coming decades (United Nations, ). With this increase comes a corresponding rise in the physical and mental health challenges associated with older age. In particular, the prevalence of SI/L in older adults is of increasing global concern (World Health Organization, ), with SI/L being linked to age-related health deterioration, including an increased risk of premature death (Steptoe et al., ; Foster et al., ), cognitive decline (Lara et al., ; Freak-Poli et al., ), neurodegenerative disease (Huang et al., ), malnutrition (Boulos et al., ) cardiovascular disease and stroke (Valtorta et al., ; Vallée, ), along with higher rates of depression, anxiety, and suicide (National Academies of Sciences Engineering and Medicine, ; Zhang et al., ).
Cross-national epidemiological data indicate that a significant percentage of older adults are adversely impacted by SI/L, including findings from the UK (Foster et al., ), Australia (Ogrin et al., ), Malaysia (Ibrahim et al., ), Canada (de Jong Gierveld et al., ), the Netherlands (Holwerda et al., ), Germany (Beller and Wagner, ; Röhr et al., ), and the USA (Anderson and Thayer, ; Cudjoe et al., ; Malani et al., ). For example, Surkalim et al. () investigated loneliness across 40 European countries, finding a prevalence in northern European countries of 4.2%−6.5% and in eastern European countries of 18.7%−24.2% for older adults. Further estimates from Gao et al. () in older adults suggest a prevalence of loneliness of between 25.3 and 32.4% in Latin American countries, 18.3% in India and 3.8% in China. However, other results for the prevalence of loneliness in older adults were 44% in India (Hossain et al., ) and 29.6% in China (Yang and Victor, ), highlighting that the specific estimates may vary depending on the study population, age groups, and measurement tools. Regarding social isolation, in Germany a prevalence of 21.7% was observed in a large cohort of older adults (Röhr et al., ). In the USA, estimates similarly indicate that 24%−34% of the elderly population are impacted by social isolation (4% characterized as severely socially isolated) and 43% by loneliness (Anderson and Thayer, ; Cudjoe et al., ). This is further supported by a representative sample of older US adults in the University of Michigan National Poll on Healthy Aging (Malani et al., ), in which participants self-reported feelings of being isolated from others (29% some of the time, 5% often), a lack of companionship (29% some of the time, 8% often) and infrequent contact (once a week or less) with people from outside their home (14% once a week, 10% every 2–3 weeks, 9% once a month or less). Viewed broadly, recent global estimates encompassing 41 studies suggest a pooled prevalence of social isolation of 26% among community-dwelling older adults (Teo et al., ). This is consistent with the recent advocacy brief of the WHO, estimating the prevalence of SI/L in older adults at 20–34% in China, Europe, Latin America, and the USA (World Health Organization, ). The brief further identifies SI/L in older adults as a global priority public health problem, noting in particular that these concerns have been made more salient by the COVID-19 pandemic.
Regarding risk, physical (e.g., Philip et al., ), psychological (e.g., Aartsen and Jylhä, ), economic (e.g., Pikhartova et al., ; Dahlberg et al., ), work/family (e.g., Chen and Feeley, ; Dahlberg et al., ), environmental (e.g., Prieto-Flores et al., ), and demographic factors (e.g., Wu and Penning, ; Perone et al., ) have each been identified as contributing to SI/L in older adults (for reviews see Nicholson, ; Dahlberg et al., ). For example, commonly identified physical risk factors for social isolation include chronic disease, hearing loss, or reduced mobility (Tomaka et al., ; National Academies of Sciences Engineering and Medicine, ; Tomida et al., ), while demographic factors include membership in minority groups (e.g. Jopling, ; Wu and Penning, ; Perone et al., ) and differences between the genders (Umberson et al., ). Examples with regard to work and family include reduced social support after retirement (Chen and Feeley, ) and/or the death of close friends or loved ones (in particular one's spouse), with both frequently identified as significant risk factor to increased social isolation in older adults (Dahlberg et al., ). Environmental contributions such as limited access to digital technology, insufficient transportation, and living in remote areas are also identified risk factors (Holt-Lunstad, ; World Health Organization, ). Importantly, much the same risk factors for loneliness in older adults have also been identified, including losing a spouse, reduced social activities, increased physical disabilities, and poor mental health (Victor et al., ; Aartsen and Jylhä, ).
Given the global issue of SI/L in older adults, numerous public policy initiatives and charities have been created to combat these negative social experiences, including in the UK (Age UK, ), Denmark (Sagen, ), Australia (Ending Loneliness Together, ), Ireland (ALONE, ), the Meuse-Rhine Euroregion (euPrevent PROFILE project, ) and New Zealand (Age Concern New Zealand, ). For example, the Campaign to End Loneliness in the UK and Ending Loneliness Together in Australia were both established to facilitate social connections among older individuals, as well as develop interventions that highlight and address SI/L in older adults (Age UK, ; Ending Loneliness Together, ). Regarding the possible types of interventions, Cotterell et al. () in their review of the topic highlight several different categories aimed at combating SI/L in older adults, including one-to-one interventions, group interventions, interventions focused on providing services, technology-based interventions, and community interventions. Such interventions can be conducted in a traditional clinical setting or be the outcome of policy initiatives in the wider community. For example, one-to-one interventions can include cognitive behavioral therapy and psychotherapy with a professional therapist (Jarvis et al., ; Smith et al., ), as well as community befriending schemes in which older adults are put in contact with volunteers with the purpose of facilitating friendships (Fakoya et al., ). Group interventions are designed to facilitate social interaction among older adults while pursuing activities based on shared interests. For example, exercise, choir, or dance groups have all been identified as potential means of reducing loneliness in older adults (Johnson et al., ; Hansen et al., ; Mays et al., ). Technology-based interventions have also gained increasing interest as a means of providing direct support for Internet and computer usage, assistance for video calls, messaging platforms, and online forums, as well as policy related to digital inclusion strategies for older adults (Shah et al., ).
Fundamentally, the principle goal of any such social intervention aimed at reducing SI/L in older adults is also to produce a corresponding measurable increase wellbeing, defined as how people evaluate the quality of their lives, drawing from their own experiences, contributions to their community, relationships, emotions, and overall functioning (Ruggeri et al., ). Importantly, the association between SI/L and negatively impacted wellbeing in older adults is well established (Leigh-Hunt et al., ; Anderson and Thayer, ; O'Súilleabháin et al., ; Cudjoe et al., ). However, it is also important to note that only limited evidence currently exists to support the effectiveness of any single, specific type of intervention, primarily due to the small number of studies for any given program (Cotterell et al., ; Gardiner et al., ; Fakoya et al., ; World Health Organization, ; Hoang et al., ). Still, when taken in together, the available evidence indicates that key features of successful interventions against SI/L in older adults involve a grounding in theoretical frameworks, a focus on prevention, providing social activities in a group setting, as well as encouraging active participation (Dickens et al., ; Cotterell et al., ).
Leisure activities and successful aging
One feature of daily life that is strongly linked to positive wellbeing is frequent engagement in leisure activities (i.e. those activities people engage in during free time; Pressman et al., ; Adams et al., ; Mock and Smale, ). Such leisure activities can include for example voluntary work, sports teams, art or music groups, theater performance, or book clubs. Importantly, benefits of leisure activities are shown to be manifold, with such activities helping older adults maintain and improve cognitive, physical, and mental health (Nimrod, ; Chang et al., ; Li J. et al., ). In addition, leisure activities are often social in nature and have been shown to explain a significant part of older people's social connectedness (Toepoel, ). There is also a strong suggestion that leisure activities are able to reduce SI/L in older adults by encouraging social engagement (Glover, ; Hajek and König, ; Teh and Tey, ; Li W. et al., ). Based on these physical, cognitive, social, and mental health benefits, efforts have been made to develop leisure activities into intervention programs capable of producing replicable improvements in health and wellbeing (Adam-Castelló et al., ), including theater-based interventions (Pestana et al., ; Noice and Noice, ). Furthermore, given the importance of leisure activities for health and wellbeing in the elderly, such engagement appears to have a crucial role for successful aging (Sala et al., ).
The successful aging model (contrasted against usual aging which focuses solely on the absence of disease), encompasses optimal aging characterized by high cognitive and physical function, low likelihood of disease and disability, and active participation in life (Rowe and Kahn, ), with more recent conceptualizations expanded to include mental health dimensions such as positive wellbeing (Pruchno et al., ; Paggi et al., ). A corollary of this definition is that individuals who are successfully aging are less likely to suffer from SI/L. Indeed, an important component within successful aging is frequent social engagement (Mendes de Leon, ), with involvement in productive social activities deemed crucial for life satisfaction in older age (Neugarten et al., ; Kim and Park, ). For this reason, various authors have highlighted the association between engaging in leisure activities and successful aging (DeCarlo, ; Chaves et al., ; Lee and Payne, ). Given that theater performance is an established leisure activity (Michalos and Kahlke, ; Pestana et al., ), we suggest that theater-based interventions with older adults may offer a structured social leisure program with the inherent goal of fostering social connectedness, wellbeing, and ultimately successful aging in older adults.
The potential of theater-based interventions to encourage social interaction, reduce social isolation and loneliness, and facilitate successful aging in older adults
In recent years, theater-based interventions have gained traction as a means of enhancing healthy cognitive aging. Pioneering work over the last 35 years by Helga and Tony Noice has demonstrated that theater-based interventions are capable of producing robust and replicable gains on numerous standard measures of cognitive functioning in older adults, including executive function, memory, language comprehension, problem solving, and creativity (for substantive reviews see, Noice et al., ; Noice and Noice, ). Building upon these findings, we propose here that along with enhancing healthy cognitive aging, theater-based interventions may also offer a potential means to encourage social interaction, reduce SI/L, and facilitate successful aging in older adults.
Broadly understood, theater-based interventions involve a group of participants coming together to undertake acting training and/or discuss, develop, and practice scripted or improvised dramas for the purpose of theatrical performance (either under the tutorage of a trained professional or as a self-directed group). Here, we understand theatrical performance as planed or spontaneous interactions between participants undertaking the goal of enacting characters in environments through pretense, embodiment, and play. Given this definition, there exists a wide variety of possible ways to implement theatrical performance as a social leisure program. As one such example, Banducci et al. () investigated whether acting training improves episodic memory recall in older adults. The intervention implemented by the researchers involved two groups; an acting training group and an active control group. Over the course of 4 weeks, both the control and intervention sessions were held twice weekly, each lasting 75 min. Additionally, there was a 15-min coffee break incorporated into the sessions to promote additional social interaction among the participants. In the acting training group, participants engaged in brief scenes with partners using drama scripts, under the tutorage of professional trainers. The acting training activities aimed to teach several main concepts related to acting performance. Firstly, participants were advised against mere “pretending” and instead encouraged to enact actions realistically. Secondly, they were prompted to imagine and mentally construct the scenarios they were to act out. Thirdly, they were taught to be driven by the goals outlined in the scripts, working through challenges to achieve their character's objectives. In the first 2 weeks, memorization of scripts wasn't required, and spontaneity in responding to interactions or changes was emphasized. Throughout the training, participants were urged to engage with these concepts intellectually, emotionally, and physically. These principles were integrated into various lessons over the intervention period. In the final 2 weeks, participants were expected to perform their scenes verbatim from memory. In contrast, the active control group took part in a theater appreciation class covering acting styles and theater history through talks, demonstrations, and video clips, controlling for improvements solely from learning about acting and social interaction. Thus, the acting group undertook both acting training and engaged in theatrical performance throughout the course of the intervention, with additional features (i.e., a coffee break) to encourage social interactions and relationship building. For other representative examples of various theater-based interventions in practice see Noice et al. (), Noice et al. (), Noice and Noice (), Noice and Noice (), Yuen et al. (), and Schwenke et al. ().
A common aspect across these theater-based interventions is their inherent social nature, conducted in peer groups and thus providing a high degree of social interaction. As discussed in the previous section, social interaction is strongly associated with reduced SI/L, successful aging, and corresponding wellbeing. Indeed, a recent study found that younger adults in a 6-weeks performing arts training program reported higher levels of psychological wellbeing after completing the program (Schwenke et al., ). Similar findings for wellbeing were also observed in older adults participating in a theater program who specifically reported enjoying the social interaction facilitated by the intervention (Yuen et al., ). Theater-based interventions can thus be viewed at as social leisure programs that facilitates social engagement and, in doing so, successful aging. There is also broad evidence indicating that participation in theater-based interventions by older adults reduces age-related risk of Alzheimer's disease and other forms of dementia (Noice and Noice, ), contrasted against SI/L which increases the risk of all-cause dementia and Alzheimer's disease (Sundström et al., ; Shen et al., ; Shafighi et al., ). In addition, theater-based interventions are often also a new experience for participants, with novelty an important aspect of stimulating cognitive and social activities associated with health across the lifespan (Hultsch et al., ; Mather, ).
Finally, interventions that facilitate social interaction have been identified are playing an important role in mitigating SI/L (Gardiner et al., ). In addition, interventions are more effective at reducing SI/L if the older adults are involved in the planning, developing and execution of activities (Wylie, ; Bartlett et al., ), with productive and challenging tasks appearing more effective than passive activities (Howat et al., ; Pettigrew and Roberts, ). Indeed, in this respect, a principle benefit of theater-based interventions is that they offer complex, varied, fulfilling, and enjoyable activities involving embodied cognitive, social, and emotional engagement (Noice and Noice, ). Participants are able to be actively involved in creating the performance, which can be adapted to their requirements (e.g., mobility). Thus, when taken together, theater-based interventions provide frequent social leisure activities that offers a high degree of planning and control to older participants, while also supplying complex and varied social, cognitive, physical, and emotional tasks that are engaging and intrinsically rewarding. For these reasons, theater-based interventions are a promising candidate for future investigations into reducing SI/L, facilitating successful aging, and promoting wellbeing in older adults.
Theater-based interventions may also strengthen social cognition in older adults
In this final section, we suggest that theater-based interventions may have the potential to strengthen social cognition in older adults. Social cognition is defined as the ability to use abstract, propositional reasoning (e.g., about thoughts, desires, or feelings) to represent others' mental processes (Happé et al., ). Importantly, this ability is an aspect of social behavior that plays a prominent role in successful social functioning (Frith and Frith, ) and maladaptive social cognition is associated with SI/L and connected harms (Cacioppo et al., ; Lieberz et al., ). Furthermore, because social cognition declines across the lifespan (Henry et al., ), social cognition is suggested to be a contributing factor in the increased SI/L observed in older adults, limiting the ability to establish or maintain social contacts (Cacioppo and Hawkley, ; de Sousa et al., ; Bland et al., ). Indeed, social cognition is a crucial factor involved in positive real-world interpersonal interactions, maintaining social relationships, and prosocial behavior (Happé et al., ; Pollerhoff et al., ; McDonald and Kanske, ) which, in turn, impact wellbeing and successful aging. Interestingly, theater-based interventions offer a range of social tasks (e.g., embodying characters) and interactions (e.g., discussing a performance with other participants) which have the potential to engage and promote social cognitive processes. We thus hypothesize that social cognition in older adults may be targeted and improved by theater-based interventions.
A growing body of evidence indicates that social abilities are not a uniform construct, but rather involve the complex interplay between multiple, separate social processes at both behavioral and neural levels (Blair, ; Shamay-Tsoory and Aharon-Peretz, ; Kanske et al., , ). In particular, a distinction is made between social cognition and social affect (Kanske, ), the latter referring to social emotional states such as empathy (sharing or mirroring of another's emotions; De Vignemont and Singer, ) and compassion (a feeling of warmth or concern toward others; Klimecki et al., ). With respect to lifespan development, many studies suggest a decline in social cognition in older age (for review see Henry et al., ; Fernandes et al., ) and a preservation or possible enhancement of social affect (Richter and Kunzmann, ; Sze et al., ; Chen et al., ; Reiter et al., ; Stietz et al., ). Supporting this are two recent cross-sectional studies comparing older and younger adults by measuring empathy, compassion, and social cognition within the same sample and naturalistic task (Kanske et al., ; Reiter et al., ; Stietz et al., ). These studies found that younger adults significantly outperform older adults in social cognition, indicating an age-related decline in social cognitive abilities, while empathy did not differ and compassion was greater in older adults. Thus, the current evidence suggests that social cognition and social affect age differently across the adult lifespan. In particular, the weight of evidence suggests that social cognition declines in older age.
With respect to strengthening social cognitive abilities, increasing data demonstrate that social cognition is in principle plastic, with mental training interventions inducing changes at both the behavioral and neural levels (Valk et al., ; Trautwein et al., ), including in older adults (Cavallini et al., ; Lecce et al., ). Moreover, there is a growing interest in the potential for various artistic endeavors to improve social cognition, including music (McDonald et al., ), film (Castano, ), dance (Koehne et al., ), and literature (Dodell-Feder and Tamir, ). Regarding improving social cognition in the context of theater-based interventions, it has been previously argued that acting training provides a potential means of improving social cognition and empathy by requiring participants to take the perspective and embody the emotions of various characters (McDonald et al., ). This theoretical argument suggests that the process of character creation and performance inherent in theatrical performance actively recruits social cognition, through which repeated engagement has the potential to foster improvements by strengthening underlying brain networks. Preliminary evidence supporting these claims comes from correlational studies, which have demonstrated that both empathy and social cognition are significantly higher in amateur and trained actors (Nettle, ; Goldstein et al., ). Or, going beyond these correlational observations, social cognition and empathy have been observed to increase in children/adolescents after acting training interventions compared to other arts training, such as visual arts or music interventions (Schellenberg, ; Goldstein and Winner, ). In addition, a growing body of research is looking into the potential of theatrical interventions for autism spectrum disorders (Corbett et al., , ; Gabriel et al., ) and schizophrenia (Mele et al., ; Tang et al., ) as a means of improving social skills, as well as in Parkinson's disease as an add-on therapeutic intervention for social and emotional rehabilitation (Mirabella et al., ).
Beyond the theoretical potential of theatrical performance, theater-based interventions are also able to directly facilitate social interactions in practice (Noice and Noice, ). Importantly, there is an association between the frequency and intensity of social interactions and the maintenance of social cognitive abilities (Pearlman-Avnion et al., ). Moreover, a restricted social circle diminishes chances to engage with the perspectives and thoughts of others, particularly those beyond one's family ties (Lecce et al., ), while those individuals with strong social connections have higher social cognition measures compared to individuals with a diminished social network (Lecce et al., ). There is additionally a link between decreased social interaction and the age-related decline in social cognition (Bailey et al., ). Thus, the fostering of varied and complex social interactions may have the potential to help maintain and improve social cognition by providing novel opportunities for older adults to reflect upon other people's mental states, feelings, and beliefs. Indeed, one of the most promising features of theater-based interventions is that they provide the practical opportunity for frequent social interactions as outlined in the previous section. We thus suggest here that theater-based interventions may be able to strengthen social cognitive abilities in older adults by (i) intrinsically encouraging participants to frequently take the mental perspective and embody the emotions of various characters, and (ii) facilitating complex and varied social interactions which help expand participants' social networks.
However, we note that no study has yet specifically examined changes in social cognition in older adults partaking in theater-based interventions. Moreover, it is unclear whether such changes could directly mediate reductions in SI/L or promote successful aging. Interestingly, in their scoping review of the field, Fakoya et al. () identify that the evaluation of interventions to reduce SI/L with older adults should go beyond questions of mere effectiveness to also identify mechanisms of action, that is, the underlying factors which facilitate SI/L reductions. Improvements in social cognition via theater-based interventions may be one such mechanism. However, we note that any mediation or moderation in SI/L reduction likely involves the interplay between numerous socio- and psychometrics (e.g., gender, depression scores, personality traits, social network size, marital status, etc.). We present social cognition as one promising, illustrative example that future studies may consider. As such, a worthwhile goal of future research will be to explore the relationships between theatrical training, improvements in social cognition, and a corresponding reduction in SI/L in older adults. Importantly, any such future investigations will benefit from having an active leisure control group (e.g., pottery, yoga, music or dance interventions) which are physical and highly stimulating but lack a specific focus on engaging social cognition, in comparison to theater-based interventions with the specific goal of engaging and improving social cognitive abilities. Second, to capture the real-world impact of theater-based interventions a clear quantification of effect sizes with regard to social cognition improvement and SI/L reduction is encouraged. Finally, with respect to the implementation and limitations, a common general issue highlighted by both policy organizations (Age UK, ; World Health Organization, ) and the academic literature (Cotterell et al., ; Hoang et al., ) is the limited evidence base supporting any specific type of intervention to reduce SI/L or encourage successful aging in older adults. Similarly, as the charity Age UK () discuss in their reports on the topic, the translation from academic papers to successful real-world interventions also constitutes a significant gap in practice (Jopling, ). Both of these issues affect theater-based interventions and future research would thus benefit from a focus on real-world applicability, as well as effectiveness and mechanism. It must also be considered whether there are issues with participation and compliance in theater-based intervention among older adults suffering from SI/L that may in turn influence the effectiveness. In a similar vein, the demographic diversity (e.g., gender, cultural background) of older populations may add further complexities to the delivery of any standardized interventions (Fakoya et al., ) and therefore must also be taken into account in future investigations and policy decisions related to theater-based interventions with older adults.
Conclusion
Ultimately, when taken together, epidemiological evidence indicates that SI/L in elderly populations represents a wide-ranging and significant healthcare challenge across nations, with multiple interrelated risk factors contributing to these social experiences. Older adults impacted by SI/L are a significant concern due to the considerable risk of negative sequelae for mental health and physical health, along with the corresponding impact on wellbeing, making the development of interventions that ameliorate these issues of direct practical importance. Here, we propose that theater-based interventions with older adults are a form of social leisure activity program that may offer a means of targeting social cognition and providing complex social interactions. In doing so, such interventions have the potential to reduce SI/L, encourage social engagement, improve wellbeing, strengthen social cognition, and ultimately facilitate successful aging in older adults.
Statements
Author contributions
BM: Writing – review & editing, Writing – original draft. AR: Writing – review & editing, Writing – original draft. PK: Writing – review & editing, Writing – original draft.
Funding
The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. AR acknowledges support from grants by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG RE 4449/1-1, SFB 940-3/B7, RTG-2660/B2) and by a 2020 BBRF Young Investigator Grant. PK was supported by grants from the Deutsche Forschungsgemeinschaft (KA 4412/2-1, KA 4412/4-1, KA 4412/5-1, KA 4412/9-1, CRC 940/CO7, IRTG 2773/P4), the European Research Council (ERC-CoG 101088582 Interact), and the European Union - NextGenerationEU with the Romanian Government (760246/28.12.2023/28.12.2023, code PNRR-III-C9-2023-I8-CF103/31.07.2023).
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
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References
1
AartsenM.JylhäM. (2011). Onset of loneliness in older adults: results of a 28 year prospective study. Eur. J. Ageing8, 31–38. 10.1007/s10433-011-0175-7
2
Adam-CastellóP.Sosa-PalancaE. M.Celda-BelinchónL.García-MartínezP.Mármol-LópezM. I.Saus-OrtegaC. (2023). Leisure programmes in hospitalised people: a systematic review. Int. J. Environ. Res. Public Health20, 3268. 10.3390/ijerph20043268
3
AdamsK. B.LeibbrandtS.MoonH. (2011). A critical review of the literature on social and leisure activity and wellbeing in later life. Ageing Soc.31, 683–712. 10.1017/S0144686X10001091
4
Age Concern New Zealand (2024). About Age Concern New Zealand. Available online at: https://www.ageconcern.org.nz/Public/Public/About/Who_We_Are.aspx?hkey=f9bd5d41-7651-4e3c-b618-4d17a3b89a7d
5
Age UK (2015). Age UK Evidence Review on Loneliness. Available online at: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health–wellbeing/rb_june15_lonelines_in_later_life_evidence_review.pdf
6
ALONE (2024). About Us. Available online at: https://alone.ie/about-us/
7
AndersonG. O.ThayerC. E. (2018). Loneliness and Social Connections: a National Survey of Adults 45 and Older. Washington, DC: AARP Foundation.
8
BaileyP. E.HenryJ. D.Von HippelW. (2008). Empathy and social functioning in late adulthood. Aging Ment. Health12, 499–503. 10.1080/13607860802224243
9
BanducciS. E.DaughertyA. M.BigganJ. R.CookeG. E.VossM.NoiceT.et al. (2017). Active experiencing training improves episodic memory recall in older adults. Front. Aging Neurosci. 9:133. 10.3389/fnagi.2017.00133
10
BartlettH.WarburtonJ.LuiC. W.PeachL.CarrollM. (2013). Preventing social isolation in later life: findings and insights from a pilot Queensland intervention study. Ageing Soc.33, 1167–1189. 10.1017/S0144686X12000463
11
BellerJ.WagnerA. (2018). Loneliness, social isolation, their synergistic interaction, and mortality. Health Psychol.37:808. 10.1037/hea0000605
12
BlairR. J. R. (2005). Responding to the emotions of others: dissociating forms of empathy through the study of typical and psychiatric populations. Conscious. Cogn. 14, 698–718. 10.1016/j.concog.2005.06.004
13
BlandA. R.RoiserJ. P.MehtaM. A.SahakianB. J.RobbinsT. W.ElliottR. (2022). The impact of COVID-19 social isolation on aspects of emotional and social cognition. Cogn. Emot. 36, 49–58. 10.1080/02699931.2021.1892593
14
BoulosC.SalamehP.Barberger-GateauP. (2017). Social isolation and risk for malnutrition among older people. Geriatr. Gerontol. Int.17, 286–294. 10.1111/ggi.12711
15
CacioppoJ. T.CacioppoS. (2018). The growing problem of loneliness. Lancet391:426. 10.1016/S0140-6736(18)30142-9
16
CacioppoJ. T.HawkleyL. C. (2009). Perceived social isolation and cognition. Trends Cogn. Sci.13, 447–454. 10.1016/j.tics.2009.06.005
17
CacioppoS.GrippoA. J.LondonS.GoossensL.CacioppoJ. T. (2015). Loneliness: Clinical import and interventions. Perspect. Psychol. Sci.10, 238–249. 10.1177/1745691615570616
18
CastanoE. (2021). Art films foster theory of mind. Humanit. Soc. Sci.8:110. 10.1057/s41599-021-00793-y
19
CavalliniE.BiancoF.BottiroliS.RosiA.VecchiT.LecceS. (2015). Training for generalization in Theory of Mind: a study with older adults. Front. Psychol.6:145923. 10.3389/fpsyg.2015.01123
20
ChangP. J.WrayL.LinY. (2014). Social relationships, leisure activity, and health in older adults. Health Psychol.33:516. 10.1037/hea0000051
21
ChavesM. L.CamozzatoA. L.EizirikC. L.KayeJ. (2009). Predictors of normal and successful aging among urban-dwelling elderly Brazilians. J. Gerontol. Ser. B: Psychol. Sci. Soc. Sci.64, 597–602. 10.1093/geronb/gbp059
22
ChenY.FeeleyT. H. (2014). Social support, social strain, loneliness, and well-being among older adults: an analysis of the Health and Retirement study. J. Soc. Pers. Relat.31, 141–161. 10.1177/0265407513488728
23
ChenY.-C.ChenC.-C.DecetyJ.ChengY. (2014). Aging is associated with changes in the neural circuits underlying empathy. Neurobiol. Aging35, 827–836. 10.1016/j.neurobiolaging.2013.10.080
24
CorbettB. A.GuntherJ. R.CominsD.PriceJ.RyanN.SimonD.et al. (2011). Brief report: theatre as therapy for children with autism spectrum disorder. J. Autism Dev. Disord. 41, 505–511. 10.1007/s10803-010-1064-1
25
CorbettB. A.IoannouS.KeyA. P.CokeC.MuscatelloR.VandekarS.et al. (2019). Treatment effects in social cognition and behavior following a theater-based intervention for youth with Autism. Dev. Neuropsychol. 44, 481–494. 10.1080/87565641.2019.1676244
26
CotterellN.BuffelT.PhillipsonC. (2018). Preventing social isolation in older people. Maturitas113, 80–84. 10.1016/j.maturitas.2018.04.014
27
CudjoeT. K. M.RothD. L.SzantonS. L. (2020). The epidemiology of social isolation: national health and aging trends study. J. Gerontol. B Psychol. Sci. Soc. Sci. 2020, 107–113. 10.1093/geronb/gby037
28
DahlbergL.McKeeK. J.FrankA.NaseerM. (2022). A systematic review of longitudinal risk factors for loneliness in older adults. Aging Ment. Health26, 225–249. 10.1080/13607863.2021.1876638
29
de Jong GierveldJ.Van der PasS.KeatingN. (2015). Loneliness of older immigrant groups in Canada: effects of ethnic-cultural background. J. Cross Cult. Gerontol. 30, 251–268. 10.1007/s10823-015-9265-x
30
de SousaP.SellwoodW.EldridgeA.BentallR. P. (2018). The role of social isolation and social cognition in thought disorder. Psychiatry Res. 269, 56–63. 10.1016/j.psychres.2018.08.048
31
De VignemontF.SingerT. (2006). The empathic brain: how, when and why?Trends Cogn. Sci.10, 435–441. 10.1016/j.tics.2006.08.008
32
DeCarloT. J. (1974). Recreation participation patterns and successful aging. J. Gerontol.29, 416–422. 10.1093/geronj/29.4.416
33
DickensA. P.RichardsS. H.GreavesC. J.CampbellJ. L. (2011). Interventions targeting social isolation in older people: a systematic review. BMC Public Health11, 1–22. 10.1186/1471-2458-11-647
34
Dodell-FederD.TamirD. I. (2018). Fiction reading has a small positive impact on social cognition: a meta analysis. J. Exp. Psychol.: General147:17131727. 10.1037/xge0000395
35
Ending Loneliness Together. (2024) About us. Available online at: https://endingloneliness.com.au/about-us/
36
euPrevent PROFILE project (2023). Preventing and Combating Loneliness in Older People? An Inspiration Guide Based on the euPrevent Profile Project. Available online at: https://euprevent.eu/wp-content/uploads/2023/06/Profile-IG-EN.pdf
37
FakoyaO. A.McCorryN. K.DonnellyM. (2020). Loneliness and social isolation interventions for older adults: a scoping review of reviews. BMC Public Health20, 1–14. 10.1186/s12889-020-8251-6
38
FakoyaO. A.McCorryN. K.DonnellyM. (2021). How do befriending interventions alleviate loneliness and social isolation among older people? A realist evaluation study. PLoS ONE16:e0256900. 10.1371/journal.pone.0256900
39
FernandesC.BarbosaF.MartinsI. P.Marques-TeixeiraJ. (2021). Aging and social cognition: a comprehensive review of the literature. Psychol. Neurosci.14:1. 10.1037/pne0000251
40
FosterH. M.GillJ. M.MairF. S.Celis-MoralesC. A.JaniB. D.NichollB. I.et al. (2023). Social connection and mortality in UK Biobank: a prospective cohort analysis. BMC Med. 21:384. 10.1186/s12916-023-03055-7
41
Freak-PoliR.WagemakerN.WangR.LysenT. S.IkramM. A.VernooijM. W.et al. (2022). Loneliness, not social support, is associated with cognitive decline and dementia across two longitudinal population-based cohorts. J. Alzheimers Dis. 85, 295308. 10.3233/JAD-210330
42
FrithC. D.FrithU. (2006). The neural basis of mentalizing. Neuron50, 531–534. 10.1016/j.neuron.2006.05.001
43
GabrielJ.AngevinE.RosenT.LernerM. D. (2016). “Use of theatrical techniques and elements as interventions for autism spectrum disorders,” in Theater and Cognitive Neuroscience, eds. G. Sofia, J. Lutterbie, N. Shaughnessy, C. Falletti, and V. Jacono (London: Bloomsbury Methuen Drama), 163–177.
44
GaoQ.PrinaA. M.PrinceM.AcostaD.Luisa SosaA.GuerraM.et al. (2021). Loneliness among older adults in Latin America, China, and India: prevalence, correlates and association with mortality. Int. J. Public Health66:604449. 10.3389/ijph.2021.604449
45
GardinerC.GeldenhuysG.GottM. (2018). Interventions to reduce social isolation and loneliness among older people: an integrative review. Health Soc. Care Community26, 147–157. 10.1111/hsc.12367
46
GloverT. D. (2019). “All the lonely people: Social isolation and the promise and pitfalls of leisure,” in Contemporary Issues in Leisure Sciences (London: Routledge), 25–35.
47
GoldsteinT. R.WinnerE. (2012). Enhancing empathy and theory of mind. J. Cogn. Dev. 13, 19–37. 10.1080/15248372.2011.573514
48
GoldsteinT. R.WuK.WinnerE. (2009). Actors are skilled in theory of mind but not empathy. Imagin. Cogn. Pers. 29, 115–133. 10.2190/IC.29.2.c
49
HajekA.KönigH. H. (2019). Impact of informal caregiving on loneliness and satisfaction with leisure-time activities. Findings of a population-based longitudinal study in Germany. Aging Mental Health23, 1539–1545. 10.1080/13607863.2018.1506739
50
HansenP.MainC.HartlingL. (2021). Dance intervention affects social connections and body appreciation among older adults in the long term despite COVID-19 social isolation: a mixed methods pilot study. Front. Psychol. 12:635938. 10.3389/fpsyg.2021.635938
51
HappéF.CookJ. L.BirdG. (2017). The structure of social cognition: in(ter)dependence of sociocognitive processes. Annu. Rev. Psychol. 8, 243–26710.1146/annurev-psych-010416-044046
52
HappéF.WinnerE.BrownellH. (1998). The getting of wisdom: theory of mind in old age. Dev. Psychol. 34, 358. 10.1037//0012-1649.34.2.358
53
HenryJ. D.PhillipsL. H.RuffmanT.BaileyP. E. (2013). A meta-analytic review of age differences in theory of mind. Psychol. Aging28:826. 10.1037/a0030677
54
HoangP.KingJ. A.MooreS.MooreK.ReichK.SidhuH.et al. (2022). Interventions associated with reduced loneliness and social isolation in older adults: a systematic review and meta-analysis. JAMA Netw. Open5, e2236676–e2236676. 10.1001/jamanetworkopen.2022.36676
55
Holt-LunstadJ. (2017). The potential public health relevance of social isolation and loneliness: prevalence, epidemiology, and risk factors. Public Policy Aging Rep. 27, 127–130. 10.1093/ppar/prx030
56
HolwerdaT. J.Van TilburgT. G.DeegD. J.SchutterN.VanR.DekkerJ.et al. (2016). Impact of loneliness and depression on mortality: results from the Longitudinal Ageing Study Amsterdam. Br. J. Psychiat.209, 127–134. 10.1192/bjp.bp.115.168005
57
HossainM. M.PurohitN.KhanN.McKyerE. L. J.MaP.BhattacharyaS.et al. (2020). Prevalence and correlates of loneliness in India: a systematic review. 10.31124/advance.11533026
58
HowatP.IredellH.GrenadeL.NedwetzkyA.CollinsJ. (2004). Reducing social isolation amongst older people implications for health professionals. Geriatrician22, 13–20. 10.3316/informit.450291051229816
59
HuangA. R.RothD. L.CidavT.ChungS. E.AmjadH.Thorpe JrR. J.et al. (2023). Social isolation and 9-year dementia risk in community-dwelling Medicare beneficiaries in the United States. J. Am. Geriat. Soc. 71, 765–773. 10.1111/jgs.18140
60
HultschD. F.HertzogC.SmallB. J.DixonR. A. (1999). Use it or lose it: engaged lifestyle as a buffer of cognitive decline in aging?Psychol. Aging14, 245–263. 10.1037//0882-7974.14.2.245
61
IbrahimR.Abolfathi MomtazY.HamidT. A. (2013). Social isolation in older Malaysians: prevalence and risk factors. Psychogeriatrics13, 71–79. 10.1111/psyg.12000
62
JarvisM. A.PadmanabhanunniA.ChippsJ. (2019). An evaluation of a low-intensity cognitive behavioral therapy mHealth-supported intervention to reduce loneliness in older people. Int. J. Environ. Res. Public Health16, 1305. 10.3390/ijerph16071305
63
JohnsonJ. K.StewartA. L.AcreeM.NápolesA. M.FlattJ. D.MaxW. B.et al. (2020). A community choir intervention to promote well-being among diverse older adults: results from the community of voices trial. J. Gerontol. Ser. B75, 549–559. 10.1093/geronb/gby132
64
JoplingK. (2015). Promising Approaches to Reducing Loneliness and Isolation in Later Life. Available online at: https://www.campaigntoendloneliness.org/wp-content/uploads/Promising-approaches-to-reducing-loneliness-and-isolation-in-later-life.pdf (accessed April 9, 2024).
65
KanskeP. (2018). The social mind: disentangling affective and cognitive routes to understanding others. Interdiscipl. Sci. Rev.43, 115–124. 10.1080/03080188.2018.1453243
66
KanskeP.BöcklerA.TrautweinF. M.Parianen LesemannF. H.SingerT. (2016). Are strong empathizers better mentalizers? Evidence for independence and interaction between the routes of social cognition. Soc. Cogn. Affect. Neurosci. 11, 1383–1392. 10.1093/scan/nsw052
67
KanskeP.BöcklerA.TrautweinF. M.SingerT. (2015). Dissecting the social brain: introducing the EmpaToM to reveal distinct neural networks and brain–behavior relations for empathy and theory of mind. Neuroimage122, 6–19. 10.1016/j.neuroimage.2015.07.082
68
KimJ.ParkG. R. (2024). Cumulative exposure to social isolation and longitudinal changes in life satisfaction among older adults. Soc. Ment. Health 21568693241232410. 10.1177/21568693241232410
69
KlimeckiO. M.LeibergS.RicardM.SingerT. (2014). Differential pattern of functional brain plasticity after compassion and empathy training. Soc. Cogn. Affect. Neurosci.9, 873–879. 10.1093/scan/nst060
70
KoehneS.BehrendsA.FairhurstM. T.DziobekI. (2016). Fostering social cognition through an imitation-and synchronization-based dance/movement intervention in adults with autism spectrum disorder: a controlled proof-of-concept study. Psychother. Psychosom.85, 27–35. 10.1159/000441111
71
LaraE.CaballeroF. F.Rico-UribeL. A.OlayaB.HaroJ. M.Ayuso-MateosJ. L.et al. (2019). Are loneliness and social isolation associated with cognitive decline?Int. J. Geriatr. Psychiatry34, 1613–1622. 10.1002/gps.5174
72
LecceS.CeccatoI.BiancoF.RosiA.BottiroliS.CavalliniE. (2015). Theory of mind and social relationships in older adults: the role of social motivation. Aging Ment. Health21, 253–258. 10.1080/13607863.2015.1114586
73
LeeC.PayneL. L. (2015). Exploring the relationship between different types of serious leisure and successful aging. Act. Adapt. Aging39, 1–18. 10.1080/01924788.2015.994415
74
Leigh-HuntN.BagguleyD.BashK.TurnerV.TurnbullS.ValtortaN.et al. (2017). An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health152, 157–171. 10.1016/j.puhe.2017.07.035
75
LiJ.ZengB.LiP. (2021). The influence of leisure activity types and involvement levels on leisure benefits in older adults. Front. Public Health9:659263. 10.3389/fpubh.2021.659263
76
LiW.SunH.XuW.MaW.YuanX.WuH.et al. (2021). Leisure activity and cognitive function among Chinese old adults: the multiple mediation effect of anxiety and loneliness. J. Affect. Disord.294, 137–142. 10.1016/j.jad.2021.07.051
77
LieberzJ.Shamay-TsooryS. G.SaportaN.EsserT.KuskovaE.Stoffel-WagnerB.et al. (2021). Loneliness and the social brain: how perceived social isolation impairs human interactions. Adv. Sci.8:2102076. 10.1002/advs.202102076
78
MalaniP.SingerD.KirchM.SolwayE.RobertsS.SmithE.et al. (2023). Trends in Loneliness Among Older Adults From 2018–2023 (University of Michigan National Poll on Healthy Aging, March 2023). Available online at: https://deepblue.lib.umich.edu/bitstream/handle/2027.42/175971/0300_NPHA-Loneliness-report-FINAL-doifinal.pdf?sequence=4&isAllowed=y
79
MatherM. (2020). How do cognitively stimulating activities affect cognition and the brain throughout life?Psychol. Sci. Public Interest21, 1–5. 10.1177/1529100620941808
80
MaysA. M.KimS.RosalesK.AuT.RosenS. (2021). The Leveraging Exercise to Age in Place (LEAP) study: engaging older adults in community-based exercise classes to impact loneliness and social isolation. Am. J. Geriatr. Psychiatry29, 777–788. 10.1016/j.jagp.2020.10.006
81
McDonaldB.BöcklerA.KanskeP. (2022). Soundtrack to the social world: Emotional music enhances empathy, compassion, and prosocial decisions but not theory of mind. Emotion22:19. 10.1037/emo0001036
82
McDonaldB.GoldsteinT. R.KanskeP. (2020). Could acting training improve social cognition and emotional control?Front. Hum. Neurosci.14:348. 10.3389/fnhum.2020.00348
83
McDonaldB.KanskeP. (2023). Gender differences in empathy, compassion, and prosocial donations, but not theory of mind in a naturalistic social task. Sci. Rep.13:20748. 10.1038/s41598-023-47747-9
84
MeleS.BiviR.BorraL.CallegariV.CaraccioloS.TugnoliS.et al. (2019). Efficacy of theatre activities in facial expression categorization in schizophrenia. Arts Psychother.63, 141–150. 10.1016/j.aip.2018.08.003
85
Mendes de LeonC. F. (2005). Social engagement and successful aging. Eur. J. Ageing2, 64–66. 10.1007/s10433-005-0020-y
86
MichalosA. C.KahlkeP. M. (2008). Impact of arts-related activities on the perceived quality of life. Soc. Indic. Res.89, 193–258. 10.1007/s11205-007-9236-x
87
MirabellaG.De VitaP.FragolaM.RampelliS.LenaF.DilettusoF.et al. (2017). Theatre is a valid add-on therapeutic intervention for emotional rehabilitation of Parkinson's disease patients. Parkinson's Dis.2017:7436725. 10.1155/2017/7436725
88
MockS. E.SmaleB. (2023). The relationship of diverse leisure activities with flourishing. Front. Psychol.14:1130906. 10.3389/fpsyg.2023.1130906
89
National Academies of Sciences Engineering and Medicine (2020). Social Isolation and loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: National Academies Press.
90
NettleD. (2006). Psychological profiles of professional actors. Pers. Individ. Dif. 40, 375–383. 10.1016/j.paid.2005.07.008
91
NeugartenB. L.HavighurstR. J.TobinS. S. (1961). The measurement of life satisfaction. J. Gerontol. 16, 134–43. 10.1093/geronj/16.2.134
92
NicholsonN. R. (2012). A review of social isolation: an important but underassessed condition in older adults. J. Prim. Prev.33, 137–152. 10.1007/s10935-012-0271-2
93
NimrodG. (2007). Retirees' leisure: Activities, benefits, and their contribution to life satisfaction. Leisure Stud.26, 65–80. 10.1080/02614360500333937
94
NoiceH.NoiceT. (2008). An arts intervention for older adults living in subsidized retirement homes. Aging Neuropsychol. Cogn. 16, 56–79. 10.1080/13825580802233400
95
NoiceH.NoiceT. (2013). Extending the reach of an evidence-based theatrical intervention. Exp. Aging Res. 39, 398–418. 10.1080/0361073X.2013.808116
96
NoiceH.NoiceT.Perrig-ChielloP.PerrigW. (1999). Improving memory in older adults by instructing them in professional actors' learning strategies. Appl. Cogn. Psychol. 13, 315–328.
97
NoiceH.NoiceT.StainesG. (2004). A short-term intervention to enhance cognitive and affective functioning in older adults. J. Aging Health16, 562–585. 10.1177/0898264304265819
98
NoiceT.NoiceH. (2018). “A Theatrical Intervention to Lower the Risk of Alzheimer's and Other Forms of Dementia,” in The Routledge Companion to Theatre, Performance, and Cognitive Science (London: Routledge), 280–290.
99
NoiceT.NoiceH. (2021). A theatrical evidence-based cognitive intervention for older adults. Drama Ther. Rev.7, 9–22. 10.1386/dtr_00058_1
100
NoiceT.NoiceH.KramerA. F. (2015). Theatre arts for improving cognitive and affective health. Act. Adapt. Aging39, 19–31. 10.1080/01924788.2015.994440
101
OgrinR.CyartoE. V.HarringtonK. D.HaslamC.LimM. H.GolenkoX.et al. (2021). Loneliness in older age: what is it, why is it happening and what should we do about it in Australia?. Austral. J. Aging40, 202–207. 10.1111/ajag.12929
102
O'SúilleabháinP. S.GallagherS.SteptoeA. (2019). Loneliness, living alone, and all-cause mortality: the role of emotional and social loneliness in the elderly during 19 years of follow- up. Psychosom. Med.81:521. 10.1097/PSY.0000000000000710
103
PaggiM. E.JoppD.HertzogC. (2016). The importance of leisure activities in the relationship between physical health and well-being in a life span sample. Gerontology62, 450–458. 10.1159/000444415
104
Pearlman-AvnionS.RonN.EzekielS. (2018). Ageing and theory of mind abilities: the benefits of social interaction. Educ. Gerontol.44, 368–377. 10.1080/03601277.2018.1480130
105
PeroneA. K.Ingersoll-DaytonB.Watkins-DukhieK. (2020). Social isolation loneliness among LGBT older adults: lessons learned from a pilot friendly caller program. Clin. Soc. Work J.48, 126–139. 10.1007/s10615-019-00738-8
106
PestanaJ. V.ValenzuelaR.CodinaN. (2020). Theatrical performance as leisure experience: its role in the development of the self. Front. Psychol.11:525864. 10.3389/fpsyg.2020.01439
107
PettigrewS.RobertsM. (2008). Addressing loneliness in later life. Aging Mental Health12, 302–309. 10.1080/13607860802121084
108
PhilipK. E.PolkeyM. I.HopkinsonN. S.SteptoeA.FancourtD. (2020). Social isolation, loneliness and physical performance in older-adults: fixed effects analyses of a cohort study. Sci. Rep. 10:13908. 10.1038/s41598-020-70483-3
109
PikhartovaJ.BowlingA.VictorC. (2016). Is loneliness in later life a self-fulfilling prophecy?Aging Ment. Health20, 543–549. 10.1080/13607863.2015.1023767
110
PollerhoffL.StietzJ.DepowG. J.InzlichtM.KanskeP.LiS. C.et al. (2022). Investigating adult age differences in real-life empathy, prosociality, and well-being using experience sampling. Sci. Rep.12:3450. 10.1038/s41598-022-06620-x
111
PressmanS. D.MatthewsK. A.CohenS.MartireL. M.ScheierM.BaumA.et al. (2009). Association of enjoyable leisure activities with psychological and physical well-being. Psychosom. Med.71, 725–732. 10.1097/PSY.0b013e3181ad7978
112
Prieto-FloresM. E.ForjazM. J.Fernandez-MayoralasG.Rojo-PerezF.Martinez-MartinP. (2011). Factors associated with loneliness of noninstitutionalized and institutionalized older adults. J. Aging Health23, 177–194. 10.1177/0898264310382658
113
PruchnoR. A.Wilson-GendersonM.CartwrightF. (2010). A two-factor model of successful aging. J. Gerontol. Ser. B: Psychol. Sci. Soc. Sci.65, 671–679. 10.1093/geronb/gbq051
114
ReiterA. M.KanskeP.EppingerB.LiS. C. (2017). The aging of the social mind-differential effects on components of social understanding. Sci. Rep.7:11046. 10.1038/s41598-017-10669-4
115
RichterD.KunzmannU. (2011). Age differences in three facets of empathy: performance-based evidence. Psychol. Aging26:6010.1037/a0021138
116
RöhrS.WittmannF.EngelC.EnzenbachC.WitteA. V.VillringerA.et al. (2021). Social factors and the prevalence of social isolation in a population-based adult cohort. Soc. Psychiatry Psychiatr. Epidemiol. 57, 1959–1968. 10.1007/s00127-021-02174-x
117
RoweJ. W.KahnR. L. (1997). Successful aging. Gerontologist37, 433–440. 10.1093/geront/37.4.433
118
RuggeriK.Garcia-GarzonE.MaguireÁ.MatzS.HuppertF. A. (2020). Well-being is more than happiness and life satisfaction: a multidimensional analysis of 21 countries. Health Qual. Life Outcomes18, 1–16. 10.1186/s12955-020-01423-y
119
SagenA. (2024). Eat Together and Create New Communities. Available online at: https://www.aeldresagen.dk/om-aeldresagen/lige-nu/sammenmed
120
SalaG.JoppD.GobetF.OgawaM.IshiokaY.MasuiY.et al. (2019). The impact of leisure activities on older adults' cognitive function, physical function, and mental health. PLoS ONE14:e0225006. 10.1371/journal.pone.0225006
121
SchellenbergE. G. (2004). Music lessons enhance IQ. Psychol. Sci15, 511–514. 10.1111/j.0956-7976.2004.00711.x
122
SchwenkeD.DshemuchadseM.RasehornL.KlarhölterD.ScherbaumS. (2021). Improv to improve: the impact of improvisational theater on creativity, acceptance, and psychological well-being. J. Creat. Mental Health16, 31–48. 10.1080/15401383.2020.1754987
123
ShafighiK.VilleneuveS.Rosa NetoP.BadhwarA.PoirierJ.SharmaV.et al. (2023). Social isolation is linked to classical risk factors of Alzheimer's disease-related dementias. PLoS ONE18:e0280471. 10.1371/journal.pone.0280471
124
ShahS. G. S.NoguerasD.van WoerdenH. C.KiparoglouV. (2021). Evaluation of the effectiveness of digital technology interventions to reduce loneliness in older adults: systematic review and meta-analysis. J. Med. Internet Res.23:e24712. 10.2196/24712
125
Shamay-TsooryS. G.Aharon-PeretzJ. (2007). Dissociable prefrontal networks for cognitive and affective theory of mind: a lesion study. Neuropsychologia45, 3054–3067. 10.1016/j.neuropsychologia.2007.05.021
126
ShenC.RollsE. T.ChengW.KangJ.DongG.XieC.et al. (2022). Associations of social isolation and loneliness with later dementia. Neurology99, e164–e175. 10.1212/WNL.0000000000201564
127
SmithR.WuthrichV.JohncoC.BelcherJ. (2021). Effect of group cognitive behavioural therapy on loneliness in a community sample of older adults: a secondary analysis of a randomized controlled trial. Clin. Gerontol.44, 439–449. 10.1080/07317115.2020.1836105
128
SteptoeA.ShankarA.DemakakosP.WardleJ. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proc. Nat. Acad. Sci.110, 5797–5801. 10.1073/pnas.1219686110
129
StietzJ.PollerhoffL.KurtzM.LiS. C.ReiterA. M.KanskeP. (2021). The ageing of the social mind: replicating the preservation of socio-affective and the decline of socio-cognitive processes in old age. R. Soc. Open Sci.8:210641. 10.1098/rsos.210641
130
SundströmA.AdolfssonA. N.NordinM.AdolfssonR. (2020). Loneliness increases the risk of all- cause dementia and Alzheimer's disease. J. Gerontol.: Ser. B75, 919–926. 10.1093/geronb/gbz139
131
SurkalimD. L.LuoM.EresR.GebelK.Van BuskirkJ.BaumanA.et al. (2022). The prevalence of loneliness across 113 countries: systematic review and meta-analysis. BMJ376:e067068. 10.1136/bmj-2021-067068
132
SzeJ. A.GyurakA.GoodkindM. S.LevensonR. W. (2012). Greater emotional empathy and prosocial behavior in late life. Emotion12:1129. 10.1037/a0025011
133
TangS. X.SeelausK. H.MooreT. M.TaylorJ.MoogC.O'ConnorD.et al. (2020). Theatre improvisation training to promote social cognition: a novel recovery-oriented intervention for youths at clinical risk for psychosis. Early Interv. Psychiatry14, 163–171. 10.1111/eip.12834
134
TehJ. K.TeyN. P. (2019). Effects of selected leisure activities on preventing loneliness among older Chinese. SSM-Popul. Health9, 100479. 10.1016/j.ssmph.2019.100479
135
TeoR. H.ChengW. H.ChengL. J.LauY.LauS. T. (2023). Global prevalence of social isolation among community-dwelling older adults: a systematic review and meta-analysis. Arch. Gerontol. Geriatr. 107:104904. 10.1016/j.archger.2022.104904
136
ToepoelV. (2013). Ageing, leisure, and social connectedness: how could leisure help reduce social isolation of older people?. Soc. Indic. Res.113, 355–372. 10.1007/s11205-012-0097-6
137
TomakaJ.ThompsonS.PalaciosR. (2006). The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. J. Aging Health18, 359–384. 10.1177/0898264305280993
138
TomidaK.ShimodaT.NakajimaC.KawakamiA.ShimadaH. (2024). Social isolation/loneliness and mobility disability among older adults. Curr. Geriatr. Rep. 13, 86–92. 10.1007/s13670-024-00414-x
139
TrautweinF. M.KanskeP.BöcklerA.SingerT. (2020). Differential benefits of mental training types for attention, compassion, and theory of mind. Cognition194:104039. 10.1016/j.cognition.2019.104039
140
UmbersonD.LinZ.ChaH. (2022). Gender and social isolation across the life course. J. Health Soc. Behav.63, 319–335. 10.1177/00221465221109634
141
United Nations (2019). World Population Prospects 2019: Highlights (ST/ESA/SER.A/423). New York, NY: United Nations.
142
ValkS. L.BernhardtB. C.TrautweinF. M.BöcklerA.KanskeP.GuizardN.et al. (2017). Structural plasticity of the social brain: differential change after socio-affective and cognitive mental training. Sci. Adv. 3:e1700489. 10.1126/sciadv.1700489
143
ValléeA. (2023). Association between social isolation and loneliness with estimated atherosclerotic cardiovascular disease risk in a UK Biobank population-based study. Int. J. Environ. Res. Public Health20:2869. 10.3390/ijerph20042869
144
ValtortaN. K.KanaanM.GilbodyS.RonziS.HanrattyB. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart102, 1009–1016. 10.1136/heartjnl-2015-308790
145
VictorC. R.ScamblerS. J.BowlingA. N. N.BondJ. (2005). The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain. Ageing Soc25, 357–375. 10.1017/S0144686X04003332
146
World Health Organization (2021). Advocacy Brief: Social Isolation and Loneliness Among Older People. Geneva: World Health Organization.
147
WuZ.PenningM. (2015). Immigration and loneliness in later life. Ageing Soc35, 64–95. 10.1017/S0144686X13000470
148
WylieS. (2012). “Social isolation and older people in canterbury,” in Age Concern Canterbury, New Zealand. Available online at: https://ageconcerncan.org.nz/wp-content/uploads/2017/01/Social_Isolation_Research_Report.pdf (accessed April 9, 2024).
149
YangK.VictorC. R. (2008). The prevalence of and risk factors for loneliness among older people in China. Aging Soc. 28, 305–327. 10.1017/S0144686X07006848
150
YuenH. K.MuellerK.MayorE.AzueroA. (2011). Impact of participation in a theatre programme on quality of life among older adults with chronic conditions: a pilot study. Occup. Ther. Int.18, 201–208. 10.1002/oti.327
151
ZhangY.KuangJ.XinZ.FangJ.SongR.YangY.et al. (2023). Loneliness, social isolation, depression and anxiety among the elderly in Shanghai: findings from a longitudinal study. Arch. Gerontol. Geriatr. 110:104980. 10.1016/j.archger.2023.104980
Summary
Keywords
social cognition, empathy, theory of mind, elderly, wellbeing, acting training, leisure activities
Citation
McDonald B, Reiter AMF and Kanske P (2024) Theater-based interventions as a means of reducing social isolation and loneliness, facilitating successful aging, and strengthening social cognition in older adults. Front. Psychol. 15:1364509. doi: 10.3389/fpsyg.2024.1364509
Received
02 January 2024
Accepted
20 May 2024
Published
28 June 2024
Volume
15 - 2024
Edited by
Hui Zeng, Central South University, China
Reviewed by
Jianfei Xie, Central South University, China
Yanfei Jin, Central South University, China
Updates
Copyright
© 2024 McDonald, Reiter and Kanske.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Brennan McDonald brennan.mcdonald@mailbox.tu-dresden.de
Disclaimer
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