Impact of a caregiver empowerment intervention within an age friendly village model on depression and loneliness in older adults: A Quasi Experimental Study

Fredy Akbar K; Syamsidar; Adi Hermawan

doi:10.35816/jiksh.v15i1.236

Authors

Fredy Akbar K Department of Nursing, STIKES Marendeng Majene, West Sulawesi https://orcid.org/0000-0003-3415-9127
Syamsidar Department of Nursing, Poltekkes Kemenkes Mamuju, West Sulawesi https://orcid.org/0009-0005-4299-2970
Adi Hermawan Department of Nursing, STIKES Amanah Makassar, South Sulawesi https://orcid.org/0009-0009-8968-4536

DOI:

https://doi.org/10.35816/jiksh.v15i1.236

Keywords:

Aged, Caregivers, Depression, Loneliness, Mental Health

Abstract

Introduction: Depression and loneliness are major contributors to morbidity and reduced quality of life among older adults, particularly in rural community settings where access to mental health services is limited. Strengthening caregiver capacity may represent a scalable strategy to improve psychological wellbeing. This study aimed to evaluate the effectiveness of a community-based caregiver empowerment program in reducing depressive symptoms and loneliness among older adults living in an age-friendly village in Indonesia.

Research Methodology: A quasi-experimental nonequivalent pretest–posttest control group design was employed. Seventy-two community-dwelling older adults (n=36 in the intervention group; n=36 in the control group) were recruited using purposive sampling. The intervention consisted of a 6-week structured caregiver empowerment program including psychoeducation, therapeutic communication training, emotional support strategies, and supervised home visits. Depression was measured using the Geriatric Depression Scale (GDS-15) and loneliness using the UCLA Loneliness Scale. Data were analysed using paired and independent t-tests and multiple linear regression (α = 0.05).

Results: The intervention group demonstrated significantly greater reductions in depressive symptoms (β = -2.88; 95% CI: -3.74 to -2.02; p < 0.001) and loneliness (β = -3.97; 95% CI: -4.98 to -2.96; p < 0.001) compared with the control group. Large effect sizes were observed for both outcomes.

Conclusion: The caregiver empowerment program was effective in improving psychological outcomes among community-dwelling older adults. Integrating structured caregiver training into age-friendly villages and primary health care services may provide a scalable, evidence-based strategy to strengthen mental health resilience in ageing populations.

References

Adıgüzel Yaşar, Y., Gencer, S., İlhan, N., & Aştı, T. (2026). The relationships between frailty and depression, loneliness, and self-neglect in older adults: A cross-sectional study. Archives of Psychiatric Nursing, 60, 151997. https://doi.org/10.1016/j.apnu.2025.151997

Badawy, W., & Shaban, M. (2025). The lonely swipe: Psychiatric nurses’ experiences with technology-mediated social isolation in older adults with depression. Archives of Psychiatric Nursing, 59, 151987. https://doi.org/10.1016/j.apnu.2025.151987

Bandyopadhyay, S. (2024). Loneliness and depression in older adults: living well in older age. Medicine, 52(11), 719–724. https://doi.org/10.1016/j.mpmed.2024.08.009

Bertin, L., Katz, J. S., Deshpande, G., & Krueger, F. (2025). Beyond the human touch: A critical review of the promise and challenges of animal- and robot-assisted therapy in loneliness and mental healthcare. Asian Journal of Psychiatry, 110, 104615. https://doi.org/10.1016/j.ajp.2025.104615

Brice, K. N., Paoletti-Hatcher, J., Wu-Chung, E. L., Lai, V. D., Argueta, D. L., Chen, M. A., Mahant, I., Denny, B. T., Green, C., Medina, L. D., Schulz, P., Stinson, J., Henry, S. K., Heijnen, C., & Fagundes, C. P. (2025). Heightened risk: Childhood trauma and anticipatory grief exacerbate the impact of loneliness on depressive symptoms and LPS-stimulated cytokines in dementia caregivers. Psychoneuroendocrinology, 179, 107523. https://doi.org/10.1016/j.psyneuen.2025.107523

Burke, L., Christiansen, J., Lasgaard, M., Demkowicz, O., Verity, L., Lau, J. Y. F., & Qualter, P. (2026). Interventions to reduce loneliness in children and adolescents (4–18 years): A systematic review and meta-analysis with narrative synthesis of study-level characteristics. Journal of Affective Disorders, 403, 121445. https://doi.org/10.1016/j.jad.2026.121445

Ernst, M., Petersen, J., Krakau, L., Reinwarth, A. C., Hettich-Damm, N., Hartmann, A., Wild, P. S., Münzel, T., Urschitz, M. S., Lackner, K., Pfeiffer, N., & Beutel, M. E. (2026). How the past shapes the present: Differential mental health trajectories in individuals with and without experiences of childhood abuse and neglect in the context of the COVID-19 pandemic. Journal of Affective Disorders, 399, 120907. https://doi.org/10.1016/j.jad.2025.120907

Goldman, N., Alemdar, M., Megges, H., Matsumoto, N., Schoenmakers, E., van den Berg, P., Lasgaard, M., Christiansen, J., Junttila, N., Goldman, A., Draxl, D., El-Osta, A., & Qualter, P. (2026). National policy responses to address loneliness: A global scoping review of 194 WHO member states. Health Policy, 165, 105553. https://doi.org/10.1016/j.healthpol.2025.105553

Hijrah, H., Norma Lala, N. S., Datu, N., Ruben, S. D., & Wang, S. L. (2025). Optimizing the Role of Family Nurses in Improving Community Health A Holistic Approach: Literature Review. Jurnal Ilmiah Kesehatan Sandi Husada, 14(1), 73–86. https://doi.org/10.35816/jiskh.v14i1.1249

Hua, Z., & Ma, D. (2024). Purpose in life moderates the relationship between loneliness and caregiving stress among family caregivers of people with mental health problems. Archives of Psychiatric Nursing, 49, 99–105. https://doi.org/10.1016/j.apnu.2024.02.009

Kascakova, N., Furstova, J., Hasto, J., & Tavel, P. (2025). Associations of multiple adverse childhood experiences, attachment insecurity and loneliness with physical and mental health difficulties in a representative Slovak sample. Preventive Medicine Reports, 50, 102982. https://doi.org/10.1016/j.pmedr.2025.102982

Kastl, A., Fettke, U., & Dobusch, L. (2026). Experiences and social constructions of loneliness in later life: Collaborative focus group discussions in Germany. Health Policy, 166, 105575. https://doi.org/10.1016/j.healthpol.2026.105575

Kehoe, L., & Van Orden, K. A. (2025). The Psychology of Social Isolation and Loneliness in Later Life. Clinics in Geriatric Medicine, 41(3), 307–327. https://doi.org/10.1016/j.cger.2025.04.004

Konstantinou, G. N., Rosenblat, J., Hales, S., Husain, M. I., & Blumberger, D. M. (2026). Psilocybin in late-life mental health: Addressing depression, loneliness, and existential anxiety. General Hospital Psychiatry, 98, 54–63. https://doi.org/10.1016/j.genhosppsych.2025.12.005

Kumar, A., Petriceks, A., & Schwartz, A. W. (2025). Social Isolation and Loneliness Among Older Adults. Clinics in Geriatric Medicine, 41(3), 289–306. https://doi.org/10.1016/j.cger.2025.05.002

Kwon, K. Y., Nam, N., & Kim, J. (2025). Adolescent loneliness and later-life depressive symptoms: The intersecting roles of gender and socioeconomic status. Social Science & Medicine, 384, 118588. https://doi.org/10.1016/j.socscimed.2025.118588

Liu, C., Liu, Y., Liu, C., Lin, R., Wang, X., Zhang, X., Wu, Y., & Wang, D. (2025). The Moderated Mediating Effects of Social Media Identity and Loneliness on the Relationship Between Problematic Internet Use and Mental Health in China: Nationwide Cross-Sectional Questionnaire Study. Journal of Medical Internet Research, 27, e57907. https://doi.org/10.2196/57907

Liu, H., Peng, Z., Wong, E. L., Jim, C. Y., Li, L., & Hou, W. K. (2026). Built environment in early life is linked to heterogeneous trajectories of loneliness from childhood to adolescence in the ABCD study. Health & Place, 97, 103568. https://doi.org/10.1016/j.healthplace.2025.103568

Özsoy, E., Griffiths, M. D., Onay, Ö. A., Karaçay, G. T., Koç, S., Erol, S., Cohen, A., & Ardiç, K. (2026). The predictive roles of Dark Triad, Big Five personality traits, loneliness, and attachment to caregivers in social media addiction: A cross-national study in Türkiye and Kyrgyzstan. Personality and Individual Differences, 252, 113598. https://doi.org/10.1016/j.paid.2025.113598

Qi, X., Liu, R., Ko, E., Pei, Y., & Wu, B. (2025). Buffering Effects of Internet Use on Caregiving-Related Health Impacts and Loneliness Among Older Informal Caregivers in California: Cross-Sectional Study. JMIR Aging, 8, e74209–e74209. https://doi.org/10.2196/74209

She, R., Newman, S. P., Kang, A., Choo, J. C. J., Khoo, E., Nandakumar, M., & Griva, K. (2025). Prognostication of Mental Health Risk Clusters on Hospitalization and Mortality in Patients With Coexisting Diabetes and Kidney Failure: The Hidden Burden of Loneliness. Kidney Medicine, 7(11), 101099. https://doi.org/10.1016/j.xkme.2025.101099

Somers, J. C., Munsell, D. S., & Kilgore, J. R. (2026). Depression, Loneliness, and Estrangement in the Geriatric Population. Physician Assistant Clinics, 11(1), 1–12. https://doi.org/10.1016/j.cpha.2025.08.001

Sun, L., Liao, Y., Gu, Z., Wan, X., & Liu, N. (2026). The association among social participation, loneliness and depression in stroke survivors: A longitudinal cross-lagged panel analysis. Journal of Psychosomatic Research, 203, 112553. https://doi.org/10.1016/j.jpsychores.2026.112553

Suprapto, S., Mulat, T. C., & Lalla, N. S. N. (2021). Nurse competence in implementing public health care. International Journal of Public Health Science (IJPHS), 10(2), 428. https://doi.org/10.11591/ijphs.v10i2.20711

Ungureanu, F. A., Parnes, M. F., Superka, J. E., Hasson-Ohayon, I., Figueroa-Restrepo, C., Maya, M. F. P. Y. M., Romero, S. A., Jiwani, Z., Horesh, D., & Brown, A. D. (2025). COVID-related loneliness moderates associations between latent profiles of emotion regulation and mental health. Psychiatry Research Communications, 5(4), 100233. https://doi.org/10.1016/j.psycom.2025.100233

Wang, X., Zhou, W., Yu, J., Chen, H., & Wang, C. (2026). Adverse childhood experiences and loneliness trajectory in middle-aged and older adults: A network analysis approach. Public Health, 253, 106199. https://doi.org/10.1016/j.puhe.2026.106199

Zhou, Y., Rees, J., Matcham, F., Patel, A., Antonelli, M., Tinker, A., Ourselin, S., & Liu, W. (2026). Development and User-Centered Evaluation of Smart Systems for Loneliness Monitoring in Older Adults: Mixed Methods Study. Journal of Medical Internet Research, 28, e81027. https://doi.org/10.2196/81027