Comparative effectiveness and acceptability of non-pharmacological interventions on improving social participation among older adults: a Bayesian network meta-analysis of randomised controlled trials.

Background: Social participation is recognised as a significant factor influencing the functional ability of older adults globally. However, current evidence remains inconclusive to determine which interventions are the most effective and widely acceptable.

Purpose: This study aimed to compare the effectiveness and acceptability of non-pharmacological interventions in improving social participation among older adults.

Methods: A comprehensive search was performed across eight electronic literature databases from inception to 1 August 2024 for randomised controlled trials. Pairwise meta-analysis and network meta-analyses were sequentially performed for direct comparisons and network meta-analysis, respectively. The surface under the cumulative ranking curve (SUCRA) was used to calculate the intervention hierarchy.

Results: A total of 54 studies involving nine types of non-pharmacological interventions and two control conditions, and 8,769 participants were included. For effectiveness, the results of the network meta-analysis identified a positive effect of multicomponent rehabilitation intervention, health education and social interaction intervention on improving social participation compared with care-as-usual (Standardized Mean Differences [SMDs] ranged from 0.32 to 0.77). For acceptability, home environment adaption, psychological intervention and social interaction intervention was significantly less acceptable than comprehensive exercise intervention (Odds Ratios [ORs] from 3.86 to 5.28). The SUCRA ranking showed that the multicomponent rehabilitation intervention ranked highest in both effectiveness and acceptability. Most comparisons were rated as `moderate' to `low' for the certainty of evidence.

Conclusion: The multicomponent rehabilitation intervention emerged as the most effective and acceptable strategy for enhancing social participation among older adults. However, further rigorous studies are needed to solidify these findings on the potential benefits of non-pharmacological interventions.