Effects of a mindfulness-based intervention versus a social contact control in alleviating loneliness among older adults: a randomised controlled trial

Background Loneliness is highly prevalent among Chinese older adults. Mindfulness-based interventions for older adults (MBOA) have demonstrated potential in alleviating loneliness. However, few studies have employed active controls with long-term follow-up. Objective This study aimed to assess the efficacy of MBOA in reducing loneliness compared with social contact control (SCC). Methods This parallel, randomised controlled trial (RCT) assigned community-dwelling lonely Chinese older adults (≥60 years) in Hong Kong to MBOA or SCC. Both interventions comprised 8 weekly 1.5-hour group-based face-to-face sessions. Assessments were conducted at baseline, postintervention and at 6-month and 12-month postrandomisation. The primary outcome was loneliness score at 12 months, analysed using analysis of covariance under the intention-to-treat approach. Secondary outcomes included depression, anxiety, health-related quality of life and healthcare utilisation. Changes in psychological measures were analysed using linear mixed models. Findings A total of 245 eligible participants were randomised to MBOA (n=123) or SCC (n=122). No significant between-group difference in primary outcome was found (mean difference=−0.14, p=0.52, effect size=−0.21), although both groups showed improvement in loneliness (within-group effect size: MBOA=−0.58, SCC=−0.31). MBOA participants reported reduced depressive symptoms and a decreasing trend in anxiety at 6 months compared with SCC. Conclusion This is the first RCT examining efficacy of MBOA in alleviating loneliness among Chinese older adults using an active control with long-term assessments. MBOA is not superior to SCC in reducing loneliness, although it may reduce psychological symptoms. Clinical implication Clinicians could consider prioritising mindfulness-based interventions for lonely older adults when depressive or anxiety symptoms are prominent.