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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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251 abstracts scored across 7 criteria. Click any article to expand criterion scores.
1. 8.8
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, biochemically verified increase in continuous smoking abstinence at 6 months with a low-burden text-messaging intervention among people with TB who smoke, plus a lower mortality rate and no clear downsides reported. The design and follow-up are strong for an implementation-friendly behavior intervention, though applicability is most direct to TB treatment settings and similar populations with mobile access.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 7.5
Smoking cessation is a core outpatient/primary-care goal, and texting support is broadly relevant; however, the study is embedded in TB clinics in Bangladesh/Pakistan and limited to patients with drug-sensitive pulmonary TB who want to quit and have phone access, which narrows direct generalizability to typical primary-care populations.
Validity, Bias Control & Precision 8.5
Multicenter cluster randomized clinical trial with good retention (91%) and biochemical verification of the primary abstinence outcome. Effect estimates include confidence intervals, and the primary effect is large and fairly precise, though cluster design and lack of blinding may leave some risk of performance/measurement bias for secondary self-reported outcomes.
Patient-Oriented Outcomes 8.5
The primary endpoint is continuous tobacco abstinence verified by carbon monoxide testing (patient-important behavior change). Secondary outcomes include mortality and TB treatment outcomes (cure/completion, default, failure), which are clearly patient-important.
Magnitude of Net Benefit 9.0
Large absolute increase in verified abstinence at 6 months (41.7% vs 15.3%) with a strong relative effect (RR 3.0). Mortality was lower (3.5% vs 7.5%; HR 0.4). Burden appears low (text messaging) and no intervention harms are reported in the abstract.
Implementability & Practicality 9.0
Text-message delivery is simple, low-intensity, and scalable where mobile phone access exists; the comparator was basic written information, suggesting minimal infrastructure requirements beyond a messaging system and content.
Practice-Changing Potential 10.0
For TB programs managing smokers, the combination of a large verified quit-rate improvement and a mortality signal supports immediate adoption of structured mHealth messaging as an adjunct to usual care, with a clear and actionable workflow.
2. 8.7
SGLT2 Inhibitors and Kidney Outcomes by Glomerular Filtration Rate and Albuminuria: A Meta-Analysis.
Overall: This large, high-quality meta-analysis of double-blind RCTs provides precise evidence that SGLT2 inhibitors reduce clinically meaningful kidney outcomes (including kidney failure) across eGFR and albuminuria subgroups, including stage 4 CKD and minimal albuminuria, making the findings broadly applicable and likely to influence outpatient prescribing decisions despite limited harms/burden reporting in the abstract.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 8.5
CKD, type 2 diabetes, and heart failure are common in primary care, and deciding whether to start/continue an SGLT2 inhibitor across eGFR and albuminuria strata is a frequent generalist decision, though some patients (advanced CKD) may be co-managed with nephrology.
Validity, Bias Control & Precision 9.5
Large meta-analysis of 10 randomized, double-blind, placebo-controlled trials (70,361 participants) with substantial event counts and consistently tight confidence intervals (e.g., HR 0.62 [0.57–0.68]), supporting high precision and low risk of bias as reported.
Patient-Oriented Outcomes 8.0
Primary outcome includes kidney failure and death due to kidney failure (patient-important), though it is a composite that also includes ≥50% eGFR decline (partly surrogate). Kidney failure alone is also reported as reduced.
Magnitude of Net Benefit 8.0
Shows a sizeable relative risk reduction for CKD progression (HR 0.62) and kidney failure (HR 0.66), with event rates provided (25.4 vs 40.3 per 1000 patient-years). Harms, discontinuation, and treatment burden are not reported in the abstract, limiting net-benefit certainty.
Implementability & Practicality 8.5
SGLT2 inhibitors are widely available outpatient medications and the message (benefit across eGFR/UACR, including stage 4 CKD and minimal albuminuria) simplifies eligibility decisions; however, real-world barriers (cost, monitoring, adverse effects) are not addressed in the abstract.
Practice-Changing Potential 9.5
Directly addresses a common clinical hesitation (advanced CKD or low/no albuminuria) and provides robust subgroup-consistent effects, likely supporting broader routine use across the kidney-function spectrum.
3. 8.6
Vaporized Nicotine Products for Smoking Cessation Among People Experiencing Social Disadvantage : A Randomized Clinical Trial.
Overall: A large randomized trial in socially disadvantaged smokers found markedly higher biochemically verified long-term abstinence with vaporized nicotine products than with nicotine replacement therapy, with fewer self-reported adverse events, making the findings highly relevant and potentially influential for primary-care smoking cessation.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 9.0
Smoking cessation is a core primary-care activity, and the trial targets a common, high-need outpatient population (socially disadvantaged adults who smoke daily and want to quit). The intervention and follow-up processes are compatible with primary-care pathways.
Validity, Bias Control & Precision 8.5
Large randomized trial (n=1045) with intention-to-treat analysis and blinded outcome ascertainment. Open-label design introduces some performance/expectation bias risk, but the primary outcome is biochemically verified, follow-up completion is fairly high (82.9%), and effect estimates are precise (credible interval provided).
Patient-Oriented Outcomes 8.5
Primary endpoint is sustained smoking abstinence (6-month continuous) with biochemical verification—highly patient-important and clinically meaningful. Adverse events are also reported, supporting patient-centered assessment beyond surrogates.
Magnitude of Net Benefit 9.5
Abstinence improved substantially: 28.4% vs 9.6% (absolute difference 18.7%). This is a large, clinically important benefit, and self-reported adverse events were less frequent in the VNP arm, supporting a favorable net benefit in this study.
Implementability & Practicality 7.0
Providing VNPs plus text support is feasible, but real-world implementation may face access, regulatory, prescribing/dispensing, and counseling infrastructure hurdles compared with standard NRT; the abstract also reflects an 8-week free supply that may not mirror routine coverage.
Practice-Changing Potential 8.8
Demonstrates a large, verified cessation advantage of VNPs over NRT in a priority population where cessation is difficult, which could meaningfully alter cessation strategies. Open-label design and potential policy/regulatory barriers may temper immediate universal uptake despite strong results.
4. 8.2
Apixaban for Extended Treatment of Provoked Venous Thromboembolism.
Overall: A well-designed blinded RCT shows a large reduction in symptomatic recurrent VTE with low major bleeding risk, using a practical regimen, making it likely to influence outpatient anticoagulation duration decisions despite single-center limitations.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 7.0
Extended anticoagulation decisions for VTE commonly arise in outpatient care, though many patients are initially managed by emergency/hospital or specialty services; applicability to generalists is moderate-to-high.
Validity, Bias Control & Precision 8.5
Double-blind randomized placebo-controlled design with clear outcomes and a sizable sample (n=600) supports credibility; single-center setting limits generalizability somewhat, but effect estimates are reasonably precise (HR 0.13; 95% CI 0.04–0.36).
Patient-Oriented Outcomes 9.0
Primary efficacy outcome (symptomatic recurrent VTE) and key safety outcomes (major and clinically relevant nonmajor bleeding, death) are directly patient-important rather than surrogate markers.
Magnitude of Net Benefit 8.5
Large absolute reduction in symptomatic recurrent VTE (10.0% to 1.3%; absolute risk reduction 8.7%, NNT ≈ 12) with very low major bleeding (1 vs 0) but increased clinically relevant nonmajor bleeding (4.8% vs 1.7%).
Implementability & Practicality 8.0
Low-dose apixaban is a commonly used oral anticoagulant with minimal routine monitoring; practical barriers may include cost/coverage and bleeding-risk counseling, but overall implementation is feasible.
Practice-Changing Potential 8.0
Provides strong randomized evidence for extended low-intensity anticoagulation in a clinically common gray zone (provoked VTE with enduring risk factors), likely to influence duration decisions if corroborated and adopted in guidelines.
5. 8.1
Effects of Sodium Glucose Cotransporter 2 Inhibitors by Diabetes Status and Level of Albuminuria: A Meta-Analysis.
Overall: This large meta-analysis of randomized trials shows consistent, clinically important reductions in kidney progression and hospitalizations with SGLT2 inhibitors across diabetes status and albuminuria strata, with reasonably precise estimates; limited harm details in the abstract temper the net-benefit certainty somewhat, but findings are highly relevant and likely to shift outpatient prescribing.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 8.0
Chronic kidney disease management and SGLT2 inhibitor use are common outpatient/primary-care decisions, including in people with and without diabetes and across albuminuria levels.
Validity, Bias Control & Precision 9.0
Large inverse-variance meta-analysis of 8 randomized placebo-controlled trials (n=58,816) with consistent effect estimates and fairly tight confidence intervals for major outcomes.
Patient-Oriented Outcomes 9.0
Reports clinically meaningful outcomes including kidney disease progression, acute kidney injury, hospitalization, and death rather than relying only on surrogate markers.
Magnitude of Net Benefit 7.5
Shows clear absolute reductions in kidney progression and hospitalizations and reduced AKI; mortality benefit is smaller/less certain in those without diabetes, and the abstract provides limited detail on other potential harms.
Implementability & Practicality 7.0
SGLT2 inhibitors are widely available and can be prescribed outpatient, but require attention to kidney function thresholds, adverse effects, and cost/access—creating some real-world friction.
Practice-Changing Potential 8.0
Addresses an active guideline uncertainty (diabetes status and albuminuria thresholds) and provides strong evidence supporting benefit across subgroups, likely influencing prescribing thresholds.
6. 8.0
Age-Adjusted D-Dimer Cutoff Levels to Rule Out Deep Vein Thrombosis.
Overall: A large, prospective multicenter validation study suggests age-adjusted D-dimer can safely rule out DVT in low/unlikely-risk patients while increasing the number who avoid further testing, with patient-important follow-up outcomes and high practical usability.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 7.0
Addresses a common outpatient diagnostic problem (suspected DVT) using tools generalists recognize (Wells score, D-dimer), though the population is emergency-department outpatients rather than typical primary-care clinics.
Validity, Bias Control & Precision 8.0
Large multicenter prospective management outcome design with standardized strategy and 3-month follow-up for symptomatic events; not randomized, but failure rates are directly measured with reported confidence intervals.
Patient-Oriented Outcomes 9.0
Primary outcome is adjudicated symptomatic venous thromboembolic events during follow-up, a patient-important safety endpoint rather than a surrogate marker.
Magnitude of Net Benefit 7.0
Meaningfully increases the proportion of patients who can avoid further testing (especially in those ≥75 years) with observed 0% failures in the key group, though the upper CI (to 2.3%) leaves some residual uncertainty and harms/burdens are not extensively detailed.
Implementability & Practicality 9.0
Age-adjusted cutoff is simple to apply (age × 10 µg/L for ≥50 years) and fits existing workflows using routinely available D-dimer assays plus clinical probability assessment.
Practice-Changing Potential 8.0
Provides prospective validation for extending an already familiar concept (age-adjusted D-dimer) to suspected leg DVT, which could reduce unnecessary imaging and streamline evaluation in real-world pathways.
7. 7.9
Sexual Trauma, Suicide, and Overdose in a National Cohort of Older Veterans.
Overall: A very large VA cohort shows precise, clinically important associations between prior military sexual trauma and later-life suicide attempts and overdose, using patient-important endpoints, but as an observational study it cannot fully rule out confounding and it does not directly evaluate an actionable intervention.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 7.5
Addresses suicide attempts, suicide death, and overdose—high-priority primary-care-relevant outcomes—though the setting is VA-wide and not explicitly primary care, and applicability to non-VA populations is uncertain.
Validity, Bias Control & Precision 7.5
Very large national longitudinal cohort with adjusted analyses and reported risk differences with CIs, supporting precision; however, observational design plus acknowledged selection bias, missingness, and possible unmeasured confounding limit causal inference.
Patient-Oriented Outcomes 9.5
Outcomes are directly patient-important and hard endpoints (nonfatal suicide attempt, death by suicide, overdose death).
Magnitude of Net Benefit 6.5
Associations are large for nonfatal/any suicide attempt (e.g., adjusted risk differences ~12% in men and ~6% in women by age 90), but fatal events show small absolute differences and the study does not test an intervention or quantify downstream harms/burdens of any monitoring strategy.
Implementability & Practicality 7.0
MST screening documentation and risk monitoring are feasible within health systems, but the abstract does not specify concrete, scalable intervention pathways or resource needs for long-term monitoring/treatment.
Practice-Changing Potential 9.5
Given the large cohort, clear associations with major outcomes, and persistence of risk regardless of PTSD status, the findings strongly support integrating MST history into long-term suicide/overdose risk assessment and follow-up.
8. 7.8
Home-Based Care for Hypertension in Rural South Africa.
Overall: A large randomized trial shows meaningful improvements in hypertension control with home-based CHW/nurse-supported care and no clear safety signal, though outcomes are largely surrogate and implementation requires system resources.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 9.0
Addresses hypertension management using community health workers, home BP monitoring, and medication delivery—highly relevant to outpatient chronic disease care, especially in resource-limited primary-care contexts.
Validity, Bias Control & Precision 8.0
Randomized controlled trial (n=774) with clearly reported effect sizes, CIs, and low loss to follow-up/strong retention; open-label design may introduce performance/measurement bias, though objective BP outcomes mitigate this.
Patient-Oriented Outcomes 4.5
Primary and key secondary outcomes are blood pressure and hypertension control (surrogate/intermediate outcomes); safety outcomes (severe adverse events, deaths) are reported but are not the main endpoints and event rates are low.
Magnitude of Net Benefit 8.5
Clinically meaningful BP reductions (~8–9 mm Hg systolic) and large absolute improvements in control rates (about +25–29 percentage points at 6 months) with similar severe adverse events and deaths across groups, suggesting favorable net benefit.
Implementability & Practicality 7.5
Requires CHW home visits, medication delivery logistics, remote nurse decision-making, and (for one arm) connected BP devices—feasible for organized systems but may face staffing, infrastructure, and scaling barriers in many settings.
Practice-Changing Potential 9.5
A large RCT in a common condition showing substantial improvement over standard clinic-based care supports shifting hypertension management toward home-based, team-enabled models where health systems can operationalize them.
9. 7.8
Ciprofloxacin versus Aminoglycoside-Ciprofloxacin for Bubonic Plague.
Overall: A randomized open-label noninferiority trial in suspected bubonic plague found oral ciprofloxacin alone had similar treatment-failure and safety rates to an injectable-then-oral regimen, offering a credible and practical simplification that could meaningfully influence treatment protocols where plague occurs.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 6.5
Addresses an acute infectious disease treatment decision and compares practical regimens, but plague is uncommon in most primary-care settings and the study is in an endemic, outbreak-prone context (Madagascar), limiting routine generalizability.
Validity, Bias Control & Precision 8.0
Randomized noninferiority trial with prespecified margin and clear primary endpoint; however, open-label design may influence some components of the composite outcome, and confirmed/probable cases analyzed are relatively modest (n=222) though confidence intervals are reported.
Patient-Oriented Outcomes 8.0
Primary outcome includes death and secondary pneumonic plague (highly patient-important), though it is a composite that also includes treatment changes that can be more clinician-driven.
Magnitude of Net Benefit 7.5
Demonstrates noninferiority with a small absolute difference in failure (0.9%) and similar adverse events, while potentially reducing injection-related burden; net benefit is mainly from simplifying therapy rather than improved efficacy.
Implementability & Practicality 8.5
All-oral ciprofloxacin for 10 days is simpler and easier to deliver than initial injectable aminoglycoside, lowering resource needs and likely improving feasibility in low-resource and outpatient contexts.
Practice-Changing Potential 8.5
For endemic settings and guidelines that currently include injectable aminoglycosides, this provides strong comparative evidence supporting a simpler oral regimen with similar outcomes and safety.
10. 7.7
Association of Weekend Warrior and Other Physical Activity Patterns With Mortality Among Adults With Diabetes : A Cohort Study.
Overall: A large, nationally based prospective cohort links meeting activity targets—even in 1–2 weekly sessions—to lower mortality in adults with diabetes, using hard outcomes, though self-reported single-time exposure measurement and residual confounding limit certainty and the findings mainly reinforce (rather than overhaul) existing counseling guidance.
View 6 Criterion Scores
Primary-Care Relevance & Applicability 9.0
Addresses a common primary-care condition (diabetes) and a routine counseling decision (how to meet physical activity targets), using a large, broadly representative U.S. adult sample.
Validity, Bias Control & Precision 6.5
Large prospective cohort with long follow-up and multivariable adjustment, but exposure is self-reported at a single time point and residual confounding/misclassification are likely; CIs are reasonably precise for most estimates.
Patient-Oriented Outcomes 10.0
Uses hard patient-important outcomes (all-cause, cardiovascular, and cancer mortality) with substantial event counts.
Magnitude of Net Benefit 7.0
Associations show meaningful relative risk reductions (e.g., HR ~0.79 for all-cause mortality; HR ~0.67 for cardiovascular mortality in weekend warriors), but absolute risk reduction and harms (e.g., injuries) are not reported in the abstract.
Implementability & Practicality 8.5
Intervention is behavioral (achieving ≥150 min/week MVPA) and aligns with existing guidelines; “weekend warrior” framing may improve feasibility for some patients, though sustained behavior change can be challenging and support resources are not described.
Practice-Changing Potential 5.0
Supports current activity recommendations and adds reassurance that condensed activity patterns may still be beneficial in diabetes, but as observational evidence it is more likely to refine counseling than to independently change practice.
Score Guide: 9-10 Exceptional 7-8 Strong 5-6 Moderate 3-4 Weak 1-2 Poor
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