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Does reminiscence therapy reduce loneliness in older adults?

Reminiscence therapy meaningfully reduces loneliness in older adults, with group, professionally led formats showing the greatest benefit.

Background

Loneliness is common and harmful among older adults, linked to depression, anxiety, chronic disease, cognitive decline, and increased mortality. Reminiscence therapy—using personal memories and life narratives—may improve social connection and well-being. This systematic review and meta-analysis evaluated the effectiveness of reminiscence therapy for reducing loneliness and compared types and delivery formats.

Patients

  • Population: Older adults (generally ≥60 years) in communities, hospitals, and long-term care facilities; most without major cognitive impairment.
  • Sample size: 22 studies (n=1,789) in the systematic review; 14 randomized controlled trials (RCTs) (n=1,039) in the meta-analysis.
  • Geography: Multinational (e.g., China, Spain, Taiwan, Italy, USA, Netherlands, Malaysia, UK).

Intervention

  • Reminiscence therapy in three main forms:
    • Simple reminiscence (most common)
    • Life review
    • Integrative reminiscence therapy
  • Format: Individual or group (≈10 participants per group).
  • Facilitators: Professionals (e.g., trained therapists/nurses) or non-professionals.
  • Dosage: 1–2 sessions/week; duration 2 weeks to 8 months.
  • Content/tools: Themes and stimuli (e.g., music, photographs, memorabilia) tailored to evoke memories and facilitate social interaction.

Control

  • Usual/routine care
  • Waitlist control
  • Attention control or health education

Outcome

  • Primary outcome: Loneliness (continuous), measured with validated tools (e.g., UCLA Loneliness Scale, De Jong Gierveld Loneliness Scale, Italian Loneliness Scale, ESTE-II).
  • Secondary (exploratory) outcomes: Subgroup effects by intervention type (simple vs life review vs integrative), delivery format (group vs individual), facilitator (professional vs non-professional), and durability of effects over time. Some individual studies assessed depression, anxiety, quality of life, sleep quality, and resilience.

Study Design

  • Design: Systematic review and meta-analysis (PRISMA 2020; Cochrane guidance); protocol registered (PROSPERO CRD42024588155).
  • Search: 11 databases (English and Chinese) to 5 July 2024; reference lists hand-searched.
  • Inclusion for meta-analysis: RCTs with validated loneliness measures and appropriate control conditions.
  • Quality appraisal: Effective Public Health Practice Project (EPHPP). Overall moderate quality: 1 strong, 13 moderate, 7 weak.

Level of Evidence

Level I (systematic review and meta-analysis of randomized controlled trials).

Follow up period

  • Primary timepoint: Post-intervention.
  • Longer-term: Additional follow-ups in some studies (weeks to several months) showed sustained but attenuating effects over time.

Results

  • Primary outcome (loneliness):
    • Across 14 RCTs (n=1,039), reminiscence therapy reduced loneliness versus control: Standardized Mean Difference (SMD) −1.52 (95% CI −2.11 to −0.93).
    • Heterogeneity was high (I²=94%); sensitivity analyses indicated robust findings.
  • Secondary outcomes (subgroups and durability):
    • By intervention type:
      • Simple reminiscence: SMD −0.68
      • Life review: SMD −0.71
      • Integrative reminiscence therapy: SMD −0.63
    • By format: Group delivery had a larger effect (SMD −1.12) than individual (SMD −0.59).
    • By facilitator: Professional-led interventions outperformed non-professional-led (SMD −4.34 vs −1.11).
    • Durability: Reductions persisted after the intervention but diminished over time (larger effects at earlier follow-up points).
    • Publication bias: Egger’s test indicated possible bias; trim-and-fill suggested minimal impact on conclusions.
  • NNT: Not applicable (continuous outcomes).

Limitations

  • High between-study heterogeneity (intervention content, format, duration, settings, and measurement tools).
  • Methodological constraints: limited reporting on randomization/blinding; overall moderate-to-low quality for many studies.
  • Potential publication bias.
  • Limited and variable long-term follow-up data; attenuation of effects over time.
  • Language restriction to English and Chinese.

Funding

No funding declared. Conflicts of interest: none declared.

Citation

Yang H, Zhong Q, Han B, Pu Y, He R, Huang K, Jiao Y, Han R, Kong Q, Jia Y, Chen L. Effects of reminiscence therapy for loneliness in older adults: a systematic review and meta-analysis. Age and Ageing. 2025;54:afaf136. doi:10.1093/ageing/afaf136.

Top Journal Rankings - February 2026

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17 abstracts scored across 7 criteria. Click any article to expand criterion scores.
1. 8.5
Effects of Sodium Glucose Cotransporter 2 Inhibitors by Diabetes Status and Level of Albuminuria: A Meta-Analysis.
Overall: Large, precise randomized-trial meta-analysis shows consistent, patient-important benefits of SGLT2 inhibitors in CKD across diabetes and albuminuria strata, with practical outpatient relevance and likely impact on prescribing despite some real-world access/monitoring friction not covered in the abstract.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 8.5
Chronic kidney disease with/without diabetes is common in outpatient primary care, and choosing/initiating SGLT2 inhibitors is a real-world generalist decision; subgrouping by UACR directly informs typical risk stratification.
Validity, Bias Control & Precision 9.5
Inverse-variance meta-analysis of 8 randomized placebo-controlled trials with a very large total sample (n=58,816) and consistently tight confidence intervals for most key outcomes supports strong credibility and precision.
Patient-Oriented Outcomes 8.5
Reports clinically meaningful outcomes including kidney disease progression, acute kidney injury, hospitalization, and death (rather than only laboratory surrogates), though details of outcome definitions are not provided in the abstract.
Magnitude of Net Benefit 8.5
Absolute event rates suggest meaningful reductions in kidney progression and hospitalizations, with mortality benefit clearer in diabetes than without; serious safety signals assessed include reduced acute kidney injury, supporting favorable net benefit in the abstract.
Implementability & Practicality 7.5
SGLT2 inhibitors are commonly prescribed oral agents, but real-world use can involve cost/access barriers and monitoring considerations in CKD that are not addressed in detail here.
Practice-Changing Potential 8.5
By showing benefits across diabetes status and across albuminuria strata with absolute effects presented, this synthesis can clarify guideline uncertainty and is likely to influence prescribing thresholds in CKD care.
2. 8.3
Age-Adjusted D-Dimer Cutoff Levels to Rule Out Deep Vein Thrombosis.
Overall: A large prospective multicenter validation suggests age-adjusted D-dimer can safely rule out DVT and reduce downstream testing, with patient-important follow-up outcomes and high practical feasibility, making it likely to influence real-world diagnostic pathways.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 7.5
Evaluates a common front-line diagnostic decision (suspected leg DVT) in outpatients, though the setting is emergency departments rather than primary-care clinics.
Validity, Bias Control & Precision 8.5
Large multicenter prospective management outcome study (n=3205) with standardized diagnostic pathway, adjudicated outcomes, and 3-month follow-up; not randomized, but precision is supported by reported confidence intervals and no observed failures in the key subgroup.
Patient-Oriented Outcomes 9.0
Primary endpoint is symptomatic venous thromboembolic events during follow-up after DVT was ruled out—directly patient-important and clinically meaningful.
Magnitude of Net Benefit 7.5
Shows a meaningful increase in patients who can avoid further imaging/testing (e.g., +7.4% additional negatives in non-high probability; larger gain in ≥75 years) with no observed missed events, though the upper CI (to 2.3%) leaves some residual uncertainty.
Implementability & Practicality 9.0
Uses widely available components (Wells score, high-sensitivity D-dimer, and ultrasound when indicated) and a simple age-adjusted threshold that is easy to apply in routine workflows.
Practice-Changing Potential 8.5
If adopted, could reduce unnecessary imaging and streamline DVT rule-out—especially in older patients—supported by prospective outcome data in a high-impact setting.
3. 8.2
SGLT2 Inhibitors and Kidney Outcomes by Glomerular Filtration Rate and Albuminuria: A Meta-Analysis.
Overall: This large RCT meta-analysis provides precise evidence that SGLT2 inhibitors reduce clinically important kidney outcomes across eGFR and albuminuria strata, making it highly relevant to outpatient care, though the abstract does not quantify harms or practical access issues.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 8.0
CKD, diabetes, and heart failure are common outpatient problems, and SGLT2 inhibitors are medications frequently initiated or continued in general practice; subgroup results by eGFR and albuminuria directly inform routine prescribing decisions.
Validity, Bias Control & Precision 9.5
Large meta-analysis of 10 randomized, double-blind, placebo-controlled trials (70,361 participants) with clear outcome definitions and consistently favorable, precise effect estimates (tight 95% CIs) across subgroups.
Patient-Oriented Outcomes 8.5
Primary outcome includes kidney failure and kidney death (patient-important), though the composite also includes ≥50% eGFR decline (partly surrogate). Kidney failure alone is also reported as a separate outcome.
Magnitude of Net Benefit 8.0
Demonstrates a clinically meaningful reduction in CKD progression (HR 0.62) with absolute event-rate reduction reported (25.4 vs 40.3 per 1000 patient-years); however, harms, discontinuations, and treatment burden are not described in the abstract, limiting net-benefit certainty.
Implementability & Practicality 7.5
SGLT2 inhibitors are straightforward to prescribe, but real-world use can involve cost/access barriers and monitoring/contraindication considerations (especially at low eGFR), which are not addressed in the abstract.
Practice-Changing Potential 7.5
By showing benefit even with stage 4 CKD and minimal albuminuria, it supports broader routine use and may shift clinician comfort/thresholds, though it mainly strengthens and extends an already widely adopted therapy class.
4. 8.2
An mHealth (Mobile Health) Intervention for Smoking Cessation in People With Tuberculosis: A Cluster Randomized Clinical Trial.
Overall: This multicenter cluster RCT shows a large, objectively verified increase in smoking abstinence (and a reported mortality reduction) with a low-burden text-messaging intervention, supporting meaningful real-world impact despite some limits in generalizability beyond TB clinic settings.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 7.0
Smoking cessation is broadly relevant to outpatient care, but the studied population and delivery setting are TB clinics in Bangladesh/Pakistan, which may limit direct generalizability to typical primary-care settings and populations.
Validity, Bias Control & Precision 8.5
A multicenter cluster randomized trial with good retention (91%) and biochemical verification of the primary outcome supports credibility; precision is reasonably strong (RR 3.0, 95% CI 2.0–4.9), though cluster design with only 27 clinics can still leave room for site-level confounding.
Patient-Oriented Outcomes 8.0
The primary outcome (continuous abstinence) is patient-important and objectively verified; mortality and TB outcomes were also reported, though key clinical TB endpoints appear secondary and not clearly improved.
Magnitude of Net Benefit 9.0
The absolute quit-rate difference is large (41.7% vs 15.3%), and mortality was lower (3.5% vs 7.5%); harms and burdens are not described but the intervention (texts) is inherently low-burden, making the benefit signal compelling from the abstract.
Implementability & Practicality 8.5
Text-message support is relatively simple to deliver and scalable where mobile access exists, with minimal clinical time and no specialized equipment beyond what’s used for verification in the study.
Practice-Changing Potential 8.0
The effect size on verified abstinence is substantial and the intervention is feasible, making it likely to influence TB program workflows; broader practice change may be tempered by setting-specific factors and limited detail on costs/implementation logistics.
5. 7.7
Prediction of Bacteremia and Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger.
Overall: This multi-cohort prospective pooled analysis shows the updated PECARN rule has high sensitivity and very high negative predictive value for invasive bacterial infection in well-appearing febrile neonates, suggesting it could safely reduce routine lumbar punctures in a subset, though it remains a diagnostic-accuracy study with practical constraints and limited direct evidence on patient outcomes or procedure reduction.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 7.5
Febrile neonates are a common high-stakes presentation that begins in primary care/urgent care, and the question (who needs LP/hospital-level evaluation) is clinically relevant, though the cohorts are from pediatric EDs and apply mainly to a narrowly defined, well-appearing subgroup.
Validity, Bias Control & Precision 8.5
Pooled analysis of multiple prospective cohorts across countries with a reasonable sample size (n=1537; 69 events) and reported CIs for accuracy metrics; however, this is not a randomized strategy trial, and selection is limited to infants who had specific labs performed.
Patient-Oriented Outcomes 8.0
The target condition is invasive bacterial infection and bacterial meningitis—highly patient-important outcomes—though the study evaluates diagnostic accuracy rather than downstream outcomes like morbidity, mortality, or procedure-related harms.
Magnitude of Net Benefit 7.0
High NPV (99.4%) and no meningitis missed in this dataset supports the potential to avoid unnecessary LPs in low-risk infants, but sensitivity is not perfect (94.2%), specificity is low, and actual reductions in procedures/harms were not measured.
Implementability & Practicality 7.5
Requires urinalysis plus blood tests including procalcitonin and ANC; these are feasible in many emergency/acute-care pathways but procalcitonin access and turnaround may be variable, and the rule is less directly actionable in typical office settings.
Practice-Changing Potential 7.5
Provides multi-cohort evidence supporting selective LP with shared decision-making in low-risk neonates, potentially influencing guideline-driven practice, but the modest event count for meningitis and absence of outcomes from a management trial temper immediate stand-alone practice change.
6. 7.7
Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial.
Overall: A multicenter open-label RCT suggests moderate daily caffeinated coffee intake reduces clinically detected AF/flutter recurrence after cardioversion with no clear safety signal and high ease of implementation, but generalizability beyond this cardiology-heavy population and potential detection bias limit certainty.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 5.5
The intervention is a simple lifestyle exposure (coffee) relevant to outpatient counseling, but the studied population is a post-cardioversion persistent AF cohort typically managed with substantial cardiology involvement, which limits direct generalist applicability.
Validity, Bias Control & Precision 7.5
Multicenter randomized clinical trial with clear allocation and follow-up, and a statistically significant effect with a reasonably informative CI (HR 0.61, 95% CI 0.42-0.89). However, the study is open-label and the endpoint is “clinically detected” recurrence, which may be susceptible to ascertainment differences.
Patient-Oriented Outcomes 7.0
Recurrence of AF/atrial flutter is patient-relevant (symptoms, need for visits/procedures), but it is not a hard outcome like stroke, hospitalization, or mortality, and detection depends on clinical recognition rather than systematic monitoring as described.
Magnitude of Net Benefit 9.0
The absolute reduction in recurrence appears clinically meaningful (47% vs 64% over 6 months), with no significant adverse-event difference reported and minimal burden from the intervention (encouraging about 1 cup/day).
Implementability & Practicality 9.5
Counseling to continue/moderately consume caffeinated coffee is low-cost, widely accessible, and requires no special equipment, monitoring, or complex workflow changes.
Practice-Changing Potential 7.5
Because it challenges common advice to avoid caffeine in AF and shows a meaningful reduction in recurrence, it could change counseling for coffee drinkers after cardioversion, though the open-label design and specific post-cardioversion population may temper immediate broad adoption.
7. 6.8
Spinal Manipulation and Clinician-Supported Biopsychosocial Self-Management for Acute Back Pain: The PACBACK Randomized Clinical Trial.
Overall: A large randomized trial in higher-risk acute/subacute low back pain shows small disability improvements (but not pain) with clinician-supported biopsychosocial self-management, with good internal validity overall but only modest clinical impact and some implementation friction.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 8.5
Targets a very common primary-care problem (acute/subacute low back pain) and uses a risk-stratification tool (STarT Back) with outcomes relevant to typical outpatient decision-making.
Validity, Bias Control & Precision 8.0
Large factorial randomized clinical trial (n=1000) with high completion (93%) and reported CIs; however, blinding is not described and interventions are inherently difficult to blind, leaving some risk of performance/expectation bias.
Patient-Oriented Outcomes 8.0
Primary outcomes are patient-reported pain intensity and disability over 1 year, and the abstract also reports the proportion achieving ≥50% improvement—both patient-important measures.
Magnitude of Net Benefit 4.5
Supported self-management produced statistically significant but small disability improvements versus medical care (about 1 point on RMDQ) and no significant pain benefit; harms/burdens are not reported, and added visits/therapy likely increase burden.
Implementability & Practicality 6.5
Implementation requires access to physical therapists/chiropractors delivering an 8-week program, which is feasible but may involve referral, visit time, and coverage/logistics beyond simple in-clinic management.
Practice-Changing Potential 5.5
Findings support clinician-supported biopsychosocial self-management for higher-risk acute/subacute LBP, but the effect size is modest and pain did not improve, making major changes to routine care less likely without additional context on cost/harms.
8. 6.5
Metformin to Improve Walking Performance in Lower Extremity Peripheral Artery Disease: The PERMET Randomized Clinical Trial.
Overall: A solid double-blind RCT in PAD without diabetes found no functional benefit from metformin and notable GI symptoms, making the main takeaway a credible ‘do not use for this purpose’ message despite easy implementability.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 6.5
Peripheral artery disease with impaired walking is commonly encountered in outpatient/primary care, but treatment decisions often involve vascular/cardiology comanagement and supervised exercise programs.
Validity, Bias Control & Precision 8.5
Multicenter randomized double-blind placebo-controlled trial with reasonably good follow-up (89%) and a clearly reported effect estimate with 95% CI; modest sample size limits precision for smaller effects.
Patient-Oriented Outcomes 7.5
Primary outcome (6-minute walk distance) and several secondary measures assess function and symptoms that matter to patients, though no hard clinical outcomes (e.g., limb events, hospitalizations, mortality) are assessed.
Magnitude of Net Benefit 1.5
No improvement in walking performance or other outcomes versus placebo (between-group difference 1.1 m with CI spanning clinically meaningful benefit and harm), with frequent GI side effects reported for metformin.
Implementability & Practicality 9.0
Metformin is inexpensive, widely available, and familiar to clinicians, requiring no specialized equipment; in this study it was used for 6 months with typical tolerability issues.
Practice-Changing Potential 6.0
As a well-designed negative trial in a major journal, it can discourage off-label metformin use to improve PAD walking performance, but it does not introduce a new effective therapy or pathway.
9. 6.0
Effect of insulin resistance on ticagrelor-versus clopidogrel-based dual antiplatelet therapy for secondary prevention of stroke in carriers of
Overall: A large trial-based post hoc analysis shows a moderate reduction in recurrent stroke with ticagrelor-ASA only in patients with low insulin resistance, but subgroup nature and missing harms/implementation details limit immediate practice change.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 6.0
Secondary stroke prevention is commonly co-managed with specialists, but primary care often continues antiplatelet management and risk-factor follow-up; applicability is moderate rather than purely primary-care centered.
Validity, Bias Control & Precision 6.5
Uses data from a large randomized trial, but this is a post hoc subgroup analysis by insulin resistance, increasing risk of chance findings despite reasonably precise hazard ratios and confidence intervals.
Patient-Oriented Outcomes 8.0
Recurrent stroke is a clearly patient-important clinical outcome (not a surrogate marker).
Magnitude of Net Benefit 5.5
In the low–insulin resistance group, ticagrelor-ASA reduced recurrent stroke (7.8% to 3.9%; HR 0.52), a moderate absolute benefit, but there was no benefit in high insulin resistance and the abstract does not report harms (e.g., bleeding/dyspnea) needed to judge net benefit.
Implementability & Practicality 5.0
Ticagrelor is clinically available, but selecting patients based on insulin resistance may add testing/workflow complexity, and no practical threshold or implementation details are provided in the abstract.
Practice-Changing Potential 5.0
Suggests treatment effect heterogeneity that could inform tailoring therapy, but being post hoc and without harms data makes it more hypothesis-generating than immediately practice-changing.
10. 5.8
Targeted Oxygen for Initial Resuscitation of Preterm Infants: The TORPIDO 30/60 Randomized Clinical Trial.
Overall: This large multicenter randomized trial found no difference in death or brain injury between starting resuscitation at FiO2 0.6 vs 0.3 in extremely preterm infants, with reasonably precise estimates and high follow-up, though lack of blinding and exclusions after randomization temper confidence. Outcomes are clinically important, but the demonstrated net benefit is essentially neutral; the main value is clarifying that either approach yields similar short-term outcomes in this setting.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 3.0
Addresses delivery-room resuscitation of extremely preterm infants (23–28 weeks) in maternity hospitals—highly important but mainly a neonatal/perinatal specialty decision rather than typical longitudinal primary-care practice.
Validity, Bias Control & Precision 7.5
Large multicenter randomized trial (31 hospitals, 6 countries) with high outcome ascertainment (~97%) and reported RR with 95% CI; however, clinicians and outcome assessors were not blinded and 172 randomized infants were excluded from the primary analysis, which raises some risk of bias.
Patient-Oriented Outcomes 8.0
Primary endpoint includes death (patient-important) combined with brain injury by 36 weeks’ corrected gestational age, which is clinically meaningful for infants and families.
Magnitude of Net Benefit 2.0
No meaningful difference in the primary outcome (46.9% vs 47.8%; RR 0.98, 95% CI 0.89–1.09), so net benefit is not demonstrated in the abstract; harms beyond escalation to FiO2 1.0 are not quantified.
Implementability & Practicality 8.0
Changing initial FiO2 from 0.3 to 0.6 is straightforward in delivery-room workflows and uses existing equipment; the protocol allows titration to standard oxygen-saturation targets.
Practice-Changing Potential 6.5
A large RCT showing no difference between two common starting oxygen strategies can support standardization and reduce uncertainty, but it does not identify a superior approach and leaves room for further safety/effectiveness trials.
Score Guide: 9-10 Exceptional 7-8 Strong 5-6 Moderate 3-4 Weak 1-2 Poor
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