Recommendations for research

The guideline committee has made the following recommendations for research.

1 Interventions

In the UK, which activity‑based interventions are most effective and cost effective at protecting older people who are at risk of a decline in their independence and mental wellbeing?

Why this is important

The evidence of effectiveness and cost effectiveness on interventions to help older people at risk is limited. At‑risk groups include those:

  • whose partner has recently died

  • who have recently separated or divorced

  • who have recently been made redundant or involuntarily retired

  • who are carers.

The only high quality cost effectiveness evidence available was on the benefits of singing, and this was not specific to any particular groups. A wide range of other activities could be explored.

It is also unclear which utility measures should be used in cost effectiveness studies of these interventions. Evidence of the most effective ways to measure the impact of interventions would inform future updates of the guideline.

2 Identifying older people at high risk

In the UK, what are the most effective ways to identify older people who at risk of a decline in their independence and mental wellbeing?

Why this is important

Evidence in this area was very limited and mainly comprised expert testimony. More and better quality evidence is important to improve the recommendations on identifying people at high risk.

3 Local coordination

In the UK, what are the key components of a local coordination role to ensure best value for money in promoting older people's independence and mental wellbeing?

Why this is important

The evidence base for recommendation 5.1.1 (to appoint a local coordinator) came mainly from expert testimony and a service mapping review (review 3). Pinpointing the elements of a local coordinator's role that make it a success and good value for money are needed to improve this recommendation. Studies would need to include relevant cost effectiveness data and measures of success.

4 Involving older people in developing interventions

In the UK, what are the most effective ways of involving older people in developing interventions to promote their independence and mental wellbeing?

Why this is important

There is no evidence on this. Studies would help providers to improve participation in interventions and that, in turn, would help more older people to maintain their independence and mental wellbeing. Evidence on effectiveness would also allow providers to better judge the levels of services needed and ensure enough places are available locally for these activities.

5 Factors that influence older people's mental wellbeing

In the UK, which factors or processes in an intervention influence older people's mental wellbeing? How do these factors interact with one another and does the importance differ for different groups?

Why this is important

The evidence base is unclear. By understanding the factors or processes that influence mental wellbeing it will be possible to design more effective interventions. For example, it would be useful to determine whether the importance of these factors and processes varies according to ethnicity, long‑term disability, level of social deprivation, gender, sexuality or geography (urban or rural). Evidence is also needed on:

  • optimal duration or intensity of the intervention

  • duration of benefits following the intervention

  • relative effectiveness of interventions provided remotely (via telephone or internet) compared with face‑to‑face

  • impact of the interactions between factors (such as between gender and social deprivation) and the size of impact?

6 Mid‑life interventions

In the UK, which mid‑life groups are currently at most risk of losing their independence or experiencing poor mental wellbeing in later life? And which interventions are most effective and cost effective in preparing these people for later life?

Why this is important

Interventions that prevent or slow down a decline in independence and mental wellbeing in mid‑life may be more cost effective than later interventions. But there is a lack of UK‑based evidence on the effectiveness and cost effectiveness of a range of interventions for this age group.

Evidence on the most effective ways of measuring the impact of these interventions could also help commissioners and providers to evaluate their services, and inform guideline updates.

  • National Institute for Health and Care Excellence (NICE)