Social isolation and loneliness among older persons in India: A qualitative evidence synthesis

Background and objectives There is a high prevalence of social isolation and loneliness among older persons in India. This review was conducted to explore the phenomenon of social isolation and loneliness among older persons in India. Methods We searched PubMed, SCOPUS, CINAHL and Google Scholar with an appropriately designed search strategy to identify qualitative or mixed methods studies that explored the phenomenon of social isolation and loneliness among elders in India with restrictions of English language papers published between 2015-2025. We adopted a thematic synthesis approach for the study. We registered this protocol in PROSPERO with the ID CRD420251267577. Results Of the 1265 total results, 21 studies were included in the synthesis. There were individual, interpersonal, community, and structural dimensions of social isolation and loneliness among elderly. Physical ailments had a bidirectional association with social isolation and loneliness, they worsened loneliness, and loneliness worsened the physical ailments. It led to a psychological feeling of abandonment, despair, sadness, and hopelessness. Spiritual pursuits acted as buffer against social isolation and loneliness. Having a positive attitude to life also mitigated social isolation and loneliness. Social networks such as clubs, entertainment activities, and parks improved socialisation. Familial factors such as changing family structure, death of a loved one, migration, inter-generational conflict, patronising protectionism towards the elderly by the children, and feeling undervalued in the family worsened the perception of loneliness. Communities, recreational facilities, health care facilities, work, and religious activities mitigated loneliness and social isolation. Structural social determinants such as environment, gender, caste, poverty, stigma, discrimination, policies that are not elder friendly contributed to social isolation and loneliness of elderly. Interpretation and conclusions There are major environmental, psychological, physical, social, familial, and spiritual dimensions for social isolation and loneliness among elderly in India. Policy interventions must address these to improve their quality of life.