Shared reading interventions to promote psychosocial well-being in older adults: a systematic review

Abstract

Participatory interventions, such as art therapy and group activities, have been shown to promote healthy aging. However, the effectiveness of shared reading among older adults requires further evidence. The aim of this systematic review was to explore the impact and effectiveness of shared reading groups in slowing cognitive impairment, improving social interaction, promoting psychosocial well-being, and enhancing functional aspects among older adults living in the community. The selection criteria included studies published in English after 2000 focusing on individuals aged 60 and above and examining the benefits of shared reading. The studies also included participants with cognitive or psychiatric conditions who were independent. Seven databases were queried for this research. A total of 11 articles met the inclusion criteria. A descriptive analysis of the included studies revealed the tools used to measure the impact of interventions on outcomes and the key results obtained. Despite variability in methodology and outcomes, the results showed that group activities can improve self-rated health and reduce depressive symptoms in older adults. Interventions that include reading as a form of cognitive stimulation enhance communication skills, contribute to well-being, improve quality of life, reduce loneliness, and increase social engagement. Shared reading has positive effects on satisfaction with social relationships and community support. The findings suggested that shared reading groups represent a promising, non-pharmacological intervention for promoting psychological health, well-being, and social interaction. This review gathers existing literature and highlights the need for further studies to explore the effectiveness of this approach and to improve its implementation.

Contribution to Health Promotion.

• Shared reading groups seem to improve mental health, reduce depressive symptoms, and foster social connections, helping older adults feel less isolated.

• These interventions seem to slow cognitive decline, maintain physical abilities, and promote psychosocial well-being in aging populations.

• The study emphasizes the importance of community-based interventions, proposing an accessible and affordable approach in promoting healthy aging.

INTRODUCTION

Aging represents a significant achievement for humanity; however, it comes along with many implications that remain a challenge for individuals, businesses, institutions, and governments (Bloom et al. 2015). Across the world, the proportion of individuals aged 60 and older is growing faster than any other age group (United Nations 2017).

The World Health Organization (WHO) introduced the term ‘active aging’ to describe the ‘process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age’. The word ‘active’ suggests the idea of continuous involvement in social, economic, cultural, spiritual, and civic activities, beyond just physical activity or workforce participation (Sadana and Michel 2019, Fallon and Karlawish 2019, Rudnicka et al. 2020).

Social engagement beyond inclusion of older adults is essential for promoting healthy aging. Social conditions, such as isolation, loneliness, and lack of social support, have been strong determinants of health outcomes (both physical and mental) in many studies. Indeed, these issues have been documented as pervasive factors of harmful emotional status, ultimately leading to worse health among older adults (Walton et al. 1991). Loneliness has been identified as a predictor of significant cognitive decline over time and is associated with a two-fold increased risk of developing Alzheimer’s disease (Donovan et al. 2017). On the other hand, building meaningful social relationships is crucial for psychological well-being, encompassing elements such as happiness and subjective well-being (Diener et al. 2002).

Various interventions can be effective in promoting well-being and sociability in older adults as well as preventing depression and cognitive impairment in this population (Clark 2011, Dickens et al. 2011, Holvast et al. 2017, Kok and Reynolds 2017, Silva et al. 2019, Chiu et al. 2020, Klimova and Pikhart 2020, Gramaglia et al. 2021, Iwano et al. 2022, Owen et al. 2022). Scientific literature shows that participatory activities have greater beneficial effects in the three areas of social, mental, and physical health, compared to those classified as non-participatory (Dickens et al. 2011). Common characteristics of effective participatory treatment were the provision of social activities and/or group support and, in general, any intervention involving engagement appears more likely to exert positive results. Interventions with activities that assigned a social role, such as volunteer or mentor, were more effective compared to those that focused on supporting participants to develop new skills (Owen et al. 2022). In the first group, five types have been identified to be more effective in promoting well-being in older adults: isolation prevention programs, outdoor activities, theatre workshops, animal-assisted activities, and meeting groups (Iwano et al. 2022). Moreover, other non-pharmacological interventions, such as psychotherapy, reminiscence therapy, physical activity (Holvast et al. 2017, Gramaglia et al. 2021), bibliotherapy and problem-solving therapy (Holvast et al. 2017), and story sharing (Gramaglia et al. 2021), have proven to be effective in the management of depression in the older adults. Silva highlights how interventions that combine multiple associated offerings, such as activities that promote physical and mental well-being, are effective in enhancing autonomy and delay functional decline in at-risk older adults (Silva et al. 2019).

Among the interventions described above, some studies analysed the effectiveness of shared reading groups, as it contributes not only to socialization and engagement but also to cognitive stimulation, aligning with the purpose of active aging. Shared reading is a group literary activity, in which participants read aloud from a book or a specific identified text with a leader to guide the conversation and group interaction, as experimented and defined by the UK organization (The Reader n.d.). It is a non-clinical intervention that has shown positive results across different groups of people and has been explored in different contexts, including vulnerable and inexperienced readers such as children in care, individuals recovering from substance misuse, prisoners, people living with dementia, parents, teachers, and those with mental or physical health conditions (The Reader 2018). Other research has focused on specific patient groups, like cancer patients (Andersen 2022) and those suffering from chronic pain (Billington et al., 2019), examining various outcomes, but also patients with mental problems (Robinson 2008a, Billington 2020, Kristensen et al. 2020, Christiansen 2021, Christiansen and Dalsgard 2021, Watkins et al., 2022) and dementia (Longden et al. 2016). Beyond these studies, the primary focus of the research is on mental health issues, with findings that appear highly promising. Moreover, it is widely studied in children (Noble 2020) or even during the first 1000 days of life (Dowdall et al. 2020, BookTrust 2021, Uthirasamy et al. 2023, Nati per leggere 2023).

To the best of our knowledge, there are not many studies that focus on the general older population who still reside in their own homes and are able to carry out everyday activities rather independently, but who are frail considering their age. The purpose of this review is to explore the impact of shared reading groups on slowing cognitive impairment, improving social interaction, and promoting psychosocial well-being among older adults aged 60 and over, living in the community.

MATERIALS AND METHODS

Research question and search strategy

The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (Moher et al. 2009).

The development of this work began with the research question: ‘Are shared reading group interventions effective in maintaining the psychosocial well-being of community-dwelling older adults?’

Based on that, the PICOS framework was developed to guide the selection of keywords for the search string:

• - Population: Older people over 60 years old.

• - Intervention: Shared reading groups—guided intervention groups comprising three or more individuals who gather to collectively read a text. The text may be read aloud by one of the participants or by the group leader.

• - Comparison: Absence of activity or other activity responding to the same outcome/no comparison.

• - Outcome: Prevention of depression, increased social interaction, improved perceived quality of life, slowing of cognitive decline, caregiver support, and enhanced functional and physical abilities.

• - Study design: No restrictions were imposed on the types of studies, except for protocol studies. All quantitative, qualitative, and mixed methods studies, and studies with or without a control group were included.

The following keywords and their synonyms were used to construct the exploratory search string: old people, shared reading, health promotion, caregiver, depression, cognitive impairment, social isolation (‘aged’ OR ‘aging’ OR ‘old adult*’ OR ‘older adult*’ OR ‘old people’ OR ‘elder*’ OR ‘senior’ OR ‘senium’ OR ‘retiree*’ OR ‘pensioner*’ OR ‘baby boomer*’) AND ((‘shared reading’ OR ‘bibliotherapy’) OR (‘reading’ AND ‘group*’ AND intervention) OR ‘book club’ OR ‘literary circle’ OR ‘reading circle’ OR ‘book discussion group’ OR ‘literature study group’ OR ‘book conversation society’ OR ‘book analysis team’) AND (‘preventive health programs’ OR ‘health promotion’ OR ‘social interaction’ OR ‘wellness’ OR ‘quality of life’ OR ‘cognitive impairment’ OR ‘cognitive deterioration’ OR ‘caregiver*’ OR ‘meaning in life’ OR ‘life satisfaction’ OR ‘stress’ OR ‘self-rated health’ OR ‘loneliness’ OR ‘social connectedness’ OR ‘recognition’ OR ‘enhancement’ OR ‘knowledge’ OR ‘shock attunement’ OR ‘mastery’ OR ‘sense of coherence’ OR ‘meaningfulness’ OR ‘empath*’ OR ‘social perception’ OR ‘emotional intelligence’ OR ‘relax*’ OR ‘health literacy’ OR ‘depression’ OR ‘dementia symptoms’ OR ‘self-manag* ability’ OR ‘social engagement’ OR ‘mental health’ OR ‘self esteem’ OR ‘self expression’ OR ‘coping’ OR ‘awareness of the experience’ OR ‘social isolation’ OR ‘memory’).

Inclusion and exclusion criteria

The criteria for selecting studies were as follows: articles published in English after the year 2000, analysing the benefits of shared reading in groups. We included studies involving healthy individuals or those with depression/cognitive impairments that did not limit autonomy, as well as studies targeting older people aged 60 and above. It is worth noting that while in many countries old age is considered to begin at 65, we included individuals aged 60 and above to account for contexts where aging onset is defined at this earlier age. Articles concerning studies involving people of various age ranges were included only if data related to individuals over 60 years old could be extracted.

Excluded from consideration were studies involving individuals lacking autonomy to participate in activities, those residing in healthcare-assisted facilities, review articles, study protocols,s and articles written in languages other than English.

Data extraction and presentation of results

Seven databases were queried for this research from the start until 11 September 2023: PubMed, Embase, PsycINFO, CINAHL, Scopus, Psychology and Behavioural Sciences Collection, and PsycArticles. The literature search yielded a total of 5059 articles from the databases, plus 2 from other sources. Results from all electronic database searches were combined using RAYYAN, a systematic review and meta-analysis software employed throughout the selection process. After removing 1826 duplicates, 3235 articles were screened by title and abstract, 3160 were excluded and 75 articles were assessed by full-text screening. For precise details of the screening process, Fig. 1 (‘PRISMA flow diagram of the search strategy’) illustrates the PRISMA diagram (Tricco et al. 2018). The studies were screened and selected by three authors, beginning with a title and abstract screening to exclude irrelevant studies. For potentially relevant studies, a selection based on the full text was performed to determine if they aligned with the inclusion and exclusion criteria. In case of uncertainty, the three authors decided whether to include the article by reaching consensus through comparison and discussion. Due to the significant variability and heterogeneity among the studies, a meta-analytical approach could not be applied. The results were summarized in three data charts in which the following information was collected for each included study: author, year of publication, country of the study, study design, sample characteristics, outcomes, tool, intervention description and timing, and main results. We analysed the results according to a descriptive analysis, identifying the characteristics of the individual studies in terms of study design, characteristics of the population included in the individual studies, timing of the intervention program, and period of data collection, study objective, and study quality (Table 1). Subsequently, we described the individual studies in terms of the outcomes pursued, including the instruments used and intervention modalities (Table 2). Finally, we categorized the four outcomes, assigning information from each study to the relevant categories, specifying the dimensions and sub-themes for each, along with the instruments used to measure the outcomes. We also provided a summary description of the evidence for each outcome and the number of studies in which each outcome was present (Table 3).

Figure 1.

PRISMA flowchart used to detail procedure of article selection.

Table 1.

Included studies: main characteristics and quality assessment score.

Title First author publication year	Study design Country Execution period	N° participants Age range Male % Population characteristics	Timing of intervention program Data collection (test/interview) period	Objective of the study	Quality score of the study
REPRINTS: Effects of an intergenerational health promotion program for older adults in Japan. (Fujiwara et al. 2009)	Non-randomized trial Japan 2004–06	141 participants 62–74 years 27% Community-dwelling older adults	Intervention program 3-month weekly of training programme for the old volunteers 18 months of reading group with children: once a week or every 2 weeks in elementary school (once a week, before the first class in the morning + during other breaks), kindergarten (30-min sessions), child centre for after-school Data collection Baseline health checkup 1° Follow-up: 9 months from baseline 2° Follow-up for health checkup	To activate senior volunteers’ intellectual activities regularly and cyclically through reading picture books with children Investigate the benefits of social role maintenance and engagement in an intellectual activity on mental health and cognitive aspects and perceived social support and social network creation and maintenance critical in sustaining mental health in the elderly	5
Participation-centred treatment for elderly with mild cognitive deficits: A ‘Book Club’ group case study. (Rotenberg-Shpigelman and Maeir 2011)	Case study Israel	5 participants 65–78 years 0% Elderly with mild cognitive impairment (MCI) in a community-based geriatric clinic	Intervention program 15 weekly sessions, each-90’ long Data collection period not made explicit	To observe the effectiveness of an occupational therapy intervention (PC-E) in enabling a positive experience of participation in a learning activity in a therapeutic setting to elderly people with mild cognitive impairment The overall goal of improving participants’ participation and interaction with the external environment/community	2
Cognitive intervention through a training program for picture book reading in community-dwelling older adults: a randomized controlled trial. (Suzuki et al. 2014)	RCT Japan	58 participants >65 years 8.6% Community-dwelling older adults based on the following criteria: (i) age 65 years and older; (ii) worried about memory problems; (iii) absence of self-reported dementia	Intervention program (based on the pilot study ‘REPRINTS’) The program was held once a week, over a 12-week period. One training session lasted approximately 2 h. Data collection -Baseline -Follow-up: 3 months after baseline	To explore the effectiveness of cognitive intervention through a training program for picture book reading in community-dwelling older adults	4
The effect of intergenerational programs on the mental health of elderly adults. (Murayama et al. 2015)	Non-randomized trial Japan 2004	80 participants 65–79 years 16.3% Community-dwelling older adults	Intervention program (based on the pilot study ‘REPRINTS’) • 3-month weekly of training programme for the old volunteers • 18 months of reading group with children: once a week or every 2 weeks in elementary school (once a week, before the first class in the morning + during other breaks), kindergarten (30-min sessions), child centre for after-school. Data collection Baseline 1 year later 2 years later	To examine the effects of this intergenerational program on participants’ SOC and depressive mood	5
Preventive effects of an intergenerational program on age-related hippocampal atrophy in older adults: The REPRINTS study. (Sakurai et al. 2018)	Quasi-experimental Japan	177 participants 63, 1–72, 9 years 17.6% Community-dwelling older adults and who participated in the REPRINTS study and consented to an initial and 6-year follow-up MRI assessment	Intervention program (based on the pilot study ‘REPRINTS’) • 3-month weekly of training programme for the old volunteers • 18 months of reading group with children: one a week or every 2 weeks in elementary school (once a week, before the first class in the morning + during other breaks), kindergarten (30-min sessions), child centre for after-school. Data collection Baseline After 6 years	To determine whether the REPRINTS program, which is a productive social engagement intervention, can prevent age‐related hippocampal atrophy and cognitive decline compared with control participants	3
Exploring the benefits of mindfulness training in healthy community-dwelling older adults: A randomized controlled study using a mixed methods approach. (Fiocco et al. 2019)	Mix-methods (quali-quantitative) Canada 2013–14	96 participants ≥65 years 27% Participants had to be at least 65 years of age, live independently in the community, and not currently engage in a regular mindfulness-based practice, including yoga and Qigong.	Intervention program The Mindfulness-based Intervention (MBI) and Reading and Relaxation Program (RRP) groups were run concurrently, each taking place during the same 8-week period, at the same time of day on different days. A total of five concurrent 8-week workshops lasting 2.5 h each were held for both the mindfulness and control conditions Data collection period not made explicit	To investigate the quantitative and qualitative benefits of mindfulness training in healthy community-dwelling older adults To determine whether baseline perceived stress moderates the effect of mindfulness training on measures of well-being	5
The effect of exercise and learning therapy on cognitive functions and physical activity of older people with dementia in Indonesia. (Juniarti et al. 2021)	RCT Indonesia 2019	90 participants >60 years 27.8% Community-dwelling older adults with dementia	Intervention program The intervention was conducted in 12 sessions (three sessions per week for 4 weeks —from April 18 to May 10, 2019), and the duration of each session was 60 min Data collection Baseline (pre-intervention) After 4 weeks (post-intervention)	To investigate the effect of the Indonesian older people exercise program (low-impact aerobics) and reading aloud on the cognitive function and performance of daily activities among older people with dementia	3
A bibliotherapeutic discourse on aging and masculinity in continuing care retirement communities. (Harel and Ayalon 2022)	Qualitative study Israel	17 participants >70 years 100% Independent older adults living in Continuing Care Retirement Communities (CCRCs)	Intervention program The intervention was conducted in eight 1-h sessions each Data collection During the intervention	To explore the role of bibliotherapy, with an emphasis on the literary elements' impact on participants in a discourse on aging masculinities in groups of men in Continuing Care Retirement Communities (CCRCs)	5
How an intergenerational book club can prevent cognitive decline in older adults: A pilot study. (Plummer et al. 2023)	Mix-methods (quali-quantitative) USA	28 participants 60–89 years 14.3% Senior adults	Intervention program Book club participants met once weekly for 1 h, for 8 weeks The first book club meeting was in person and then alternated between in-person and Zoom every other week Data collection At baseline (pre-testing) 9–10 weeks after the pre-testing (post-testing)	To examine how weekly meetings in an intergenerational book club could affect older adults’ subjective well-being and cognition. We predicted that well-being and cognition would improve following participation in the book club	2
Approaching literary connectivity: Early reflections on a ‘Shared Reading’ intervention in the light of post critical thought. (Pihl et al., 2024)	Qualitative study Denmark 2019–20	30 participants 65–75 years 100% Men retired or nearing retirement	Intervention program Shared reading sessions in project ‘Read, Man!’ were carried out as 8-week-long interventions The interventions consisted of a weekly meeting-day Data collection During the intervention At the conclusion of the courses	Interplay between the literary text and the social connectivity in the group	4
‘We’re opening 20 doors!’: Exploring the collective dimensions of shared reading as mental health promotion among newly retired men in Denmark. (Kristensen et al. 2023)	Explorative intervention study Denmark 2019–21	53 participants >65 years 100% Men retired or nearing retirement	Intervention program The intervention was structured around weekly 2-h SR sessions that ran over a period of 8–10 weeks. 4 courses were carried out as physical reading groups (in different geographical locations in Denmark), while the remaining 4 were carried out as online reading groups due to COVID-19 Data collection During the intervention At the conclusion of the courses Interviews were conducted in five time periods (fall 2019, spring 2020, fall 2020, spring 2021, and fall 2021)	To understand the impact of the SR experience on participants and to explore the potentials of SR as mental health promotion, this study will therefore investigate collective dimensions of the SR experience among newly retired men	5

Table 2.

Included studies: description of outcomes, tools, and interventions

Study reference	Outcomes declared in the study	Tools used within the study for initial assessments and/or at follow-up	Intervention description
REPRINTS: effects of an intergenerational health promotion program for older adults in Japan. (Fujiwara et al. 2009)	Enhancing: • functional capacity, • psychological health, • self-esteem level, • social participation, social network, social support, • cognitive function (episodic memory, language ability, and intelligence), • physical performance	1) Social role in TMIG Index of competence scale 2) Geriatric Depression Scale (GDS) 3) Rosenberg’s 10-item scale 4) Social activity checklist 5) Amount of daily contact with people with relatives, business acquaintances, neighbours, and others and frequency of contact 6) Social support scale 7) ‘Story Recall’ test from the Japanese version of the Rivermead behavioral memory test (RBMT) 8) Phonological and semantic verbal fluency tests 9) 3 subtests of Japanese version of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) (Information, Picture Completion, and Digit Symbol) 10) Walking speed, one-leg standing duration test, grip strength, and elaboration of fingers; blood pressure measure 11) Self-rated health	Experimental group • ‘REPRINTS’ educates and engages senior volunteers in picture book reading to young and school-aged children in educational settings. • The program provided the senior volunteers with intensive initial learning opportunities during 3-month weekly training sessions. • After finishing the training seminars, the volunteers were divided into groups of 6–10 volunteers to visit 5 elementary schools, 3 kindergartens, and 6 childcare centres for after-school children. • Each group had regular meetings before and after reading sessions. Control group • Individuals in the control group engaged in conventional social activities and participated in the same health checkup as experimental group, but did not take part in a specific training or program.
Participation-centered treatment for elderly with mild cognitive deficits: A ‘Book Club’ group case study. (Rotenberg-Shpigelman and Maeir 2011)	Increasing: • participants’ participation and interaction with the external environment/community • acquisition of internal strategies (memory and executiveness) • modification of negative beliefs (stress management techniques and knowledge about stress, cognition, occupation)	1) Occupational therapist’s (A.M.’s) treatment log	Intervention group • Participants identified reading literature as a past interest they wished to re-engage again, so ‘book club’ became the chosen learning activity. • In the first unit, designed to enable successful participation in the ‘book club’, all clients regularly attended, actively participated in the reading activity. • In the second unit, designed to increase community participation, a dramatic improvement in overall participation levels in community life was observed. Each participant identified a personal occupational goal, and the group offered support in planning and monitoring its attainment. • The weekly meetings began with a nurturing activity of drinking hot beverages together, and in subsequent meetings participants brought homemade cakes and herbs from their gardens.
Cognitive intervention through a training program for picture book reading in community-dwelling older adults: A randomized controlled trial. (Suzuki et al. 2014)	Enhancing cognitive function (memory capacity, executive and attention function)	1) Logical Memory (LM)I e II subscale from Wechsler Memory Scale Revised (WMS-R) 2) Subtests of Wechsler Adult Intelligence Scale-III 3) Digit Span Forward (DSF) and Backward (DSB) 4) Trail-making test (TMT) Part A e Part B 5) Kana pick-out test (KPT) 6) Verbal fluency tests 7) Mini-Mental State Examination (MMSE) 8) Japanese version of the Montreal Cognitive Assessment (MoCA-J)	Experimental group • The group started the picture book reading program (‘REPRINTS’). Control group • The group participated in lectures about elderly health maintenance once a month (three times in total).
The effect of intergenerational programs on the mental health of elderly adults. (Murayama et al. 2015)	Enhancing the sense of coherence Reducing depressive mood	1) SOC-13 (sense of coherence: comprehensibility, manageability, and meaningfulness) 2) GDS-S-J	Experimental group • ‘REPRINTS’ educates and engages senior volunteers in picture book reading to young and school-aged children in educational settings. • The program provided the senior volunteers with intensive initial learning opportunities during 3-month weekly training sessions. • After finishing the training seminars, the volunteers were divided into groups of 6–10 volunteers to visit 5 elementary schools, 3 kindergartens, and 6 childcare centres for after-school children. • Each group had regular meetings before and after reading sessions. Control group • Individuals in the control group engaged in conventional social activities and participated in the same health checkup as experimental group, but did not take part in a specific training or program.
Preventive effects of an intergenerational program on age-related hippocampal atrophy in older adults: The REPRINTS study. (Sakurai et al. 2018)	Enhancing: • cognitive functions • functional status • physical abilities Reducing depressive symptoms Preventing of hippocampal atrophy	1) MMSE 2) Rivermead behavioural memory test (RBMT), story recall 3) Trail‐making tests (TMT‐A and ‐B) 4) Verbal fluency tests 5) Subtests of the Wechsler Adult Intelligence Scale‐R (WAIS‐R) (such as picture completion, digit symbol, and information tests) 6) IADL 7) ADL 8) GDS-15 9) Testing grip strength and 5‐m walking speed at a normal pace 10) 3D-MRI images 11) TMIG index of competence 12) Interviews for medical history data 13) Phenotyping using isoelectric focusing and immunoprecipitation for the assessment of the apolipoprotein E ε4 allele (ApoE4) presence	Experimental group • ‘REPRINTS’ educates and engages senior volunteers in picture book reading to young and school-aged children in educational settings. • The program provided the senior volunteers with intensive initial learning opportunities during 3-month weekly training sessions. • After finishing the training seminars, the volunteers were divided into groups of 6–10 volunteers to visit 5 elementary schools, 3 kindergartens, and 6 childcare centres for after-school children. • Each group had regular meetings before and after reading sessions. Control group • Individuals in the control group engaged in conventional social activities and participated in the same health checkup as experimental group, but did not take part in a specific training or program.
Exploring the benefits of mindfulness training in healthy community-dwelling older adults: A randomized controlled study using a mixed methods approach. (Fiocco et al. 2019)	Reducing stress	1) Stress Assessment Inventory (health habits, social support network, type A behaviour, cognitive resilience, problem-focused coping, negative and positive thoughts) 2) The Perceived Stress Scale (PSS) 3) Qualitative questions modelled after the semi-structured interview	Experimental group1-Mindfulness-based intervention (MBI) • The course included didactic teachings about the stress response and stress physiology and intensive experiential training in mindfulness to cultivate attention and awareness of present moment experiences, coupled with an attitude of nonjudgement and acceptance. Participants were asked to engage in formal practices 30 min each day. Control group-Reading and Relaxing Program (RRP) • The group was made up of a reading component and a relaxation component (i.e. progressive muscle relaxation; PMR) and was designed to control for the non-specific aspects of the MBI program. In the first half of each weekly session, the group facilitator led participants in a discussion about their thoughts on a short story, like a book club. The PMR component of the group took place in the second half of the session and followed a modified protocol.
The effect of exercise and learning therapy on cognitive functions and physical activity of older people with dementia in Indonesia. (Juniarti et al. 2021)	Enhancing: • cognitive functions • functional aspects	1) Mini-Mental State Exam (MMSE) 2) Physical Activity Scale for the Elderly (PASE)	Experimental group • The intervention group was given treatment in the form of older people exercise program and a reading aloud activity that involved loud reading, listening, writing, and concluding a story. • The intervention began with a reading aloud activity for 30 min. In this intervention, the older people were asked to read a story that had been previously provided, conclude the story, provide responses to the content, and write their conclusions in the activity book. • After the reading aloud activity, participants were given a 5-min break, and then the second intervention (i.e. the aerobic exercise: warming up (5 min), core exercise comprising various aerobic movements (20 min), and cooling down (5 min)) was led by the instructor for 30 min. Control group • The control group was involved in an older people daily activities program conducted by a local community health centre (known as ‘puskesmas’ in Indonesian) which consists of health checkups, health education, and once a month regular exercise.
A bibliotherapeutic discourse on aging and masculinity in continuing care retirement communities. (Harel and Ayalon 2022)	Supporting: • acceptance of the aging process • sense of positive aging • coping strategy	1) Written guidelines were used as semi-structured group interviews. The facilitator conducted the group discussions. (‘How does the image of the olive tree in the poem make you feel?’; ‘Which sentence in the poem can you identify with? Please explain’; ‘What do you think about the life routine that the author describes?’) All the sessions were audio recorded and later transcribed verbatim.	Intervention group • Participants underwent a bibliotherapy group intervention. • In each session, the facilitator read aloud to the group texts about aging taken from Israeli literature and focused on a specific topic related to old age, for example: body image, family relationships, friendship, and sexuality. The order of the topics was determined based on the level of intimacy it requires from the group. • The participants were invited to reflect upon their life and to share thoughts, emotions, opinions, and experiences. • Written guidelines were used as semi-structured group interviews. The facilitator conducted the group discussions. All the sessions were audio recorded and later transcribed verbatim.
How an intergenerational book club can prevent cognitive decline in older adults: A pilot study. (Plummer et al. 2023)	Enhancing: • cognitive function • social engagement	Quantitative data 1) Montreal Cognitive Assessment (MoCA) 2) Semantic fluency subtest 3) Depression Anxiety Stress Scales (DASS21) Geriatric Depression Scale (GDS) 4) Older People’s Quality of Life-brief (OPQOL-brief) Qualitative data Additionally, qualitative data were collected using responses from focus group discussions which were led by a Social Work professor in the last book club meeting.	Intervention group • Two community locations were available, one on the university campus and one at a senior community centre close to campus. Participants selected the book club that was in the most convenient location and fit their schedules. The two book clubs were each led by a graduate student in speech-language pathology who had previous clinical practice and research experience with older adults. Both leaders followed the same script with questions to guide conversations. Additionally, one of the investigators joined one to two sessions for each group to assure that the two groups were following the same procedure.
Approaching literary connectivity: Early reflections on a ‘Shared Reading’ intervention in the light of post critical thought. (Pihl et al., 2024)	Enhancing social participation	1) Participant observations of the shared reading sessions 2) Group interviews with participants at the conclusion of the shared reading courses.	Intervention group • Shared reading sessions is facilitated by the Danish organization Læseforeningen (Eng.: The Danish Reader Association). During each session, a short story and a poem is read aloud by the reading guide, and breaks are introduced to allow for collective reflection and discussion. • The interventions consisted of a weekly meeting-day with the participation of 6–10 men per intervention.
‘We’re opening 20 doors!’: Exploring the collective dimensions of shared reading as mental health promotion among newly retired men in Denmark. (Kristensen et al. 2023)	Enhancing: • social participation • psychological health (depression)	1) Participant observations of the Shared Reading sessions 2) Group interviews with participants at the conclusion of the shared reading courses. 3) Logbooks of participants	Experimental group • All shared reading sessions are facilitated by a trained reading guide who selects and reads aloud texts within the reading group. During the reading, the reading guide pauses to make room for common discussion around the text, with an aim to facilitate collective exploration of participants’ reflections and experiences based on the texts. The reading guide is trained in facilitating both textual and social engagement within the reading groups and does this by posing questions about both literary aspects of the text and subjective reading experiences, and guiding discussion among participants. • Each course included 3–10 participants.

Table 3.

Description of outcomes and tools for their measurement

Outcomes	Outcome description	Tools
Promoting/enhancing psychosocial health and well-being	- Psychological and mental well-being and depressive symptoms - Stress perception - Level of self-esteem - Sense of coherence, competence, self-efficacy - Acceptance of aging process and coping	- Geriatric Depression Scale (Fujiwara et al. 2009, (Murayama et al. 2015, Plummer et al. 2023) - Depression Anxiety Stress Scales-DASS21 (Plummer et al. 2023) - Changing in negative beliefs through referred perception (Rotenberg-Shpigelman and Maeir 2011) - Stress Assessment Inventory (StressScan; Nowack, 2013) (Fiocco et al. 2019) - Adaptation of the Cognitive Processing Therapy: Therapist Adherence and Competence (Fiocco et al. 2019) - Rosenberg’s 10-item scale (Fujiwara et al. 2009) - Sense of Coherence Scale SOC-13 (comprehensibility, manageability, and meaningfulness) (Murayama et al. 2015) - Investigation regarding acceptance of the aging process, sense of positive aging, coping (Harel and Ayalon 2022) - Investigation of awareness, affective well-being, and sense-making/meaning-making (Kristensen et al. 2023) - Semi-structured interviews (Fiocco et al. 2019) - Older People’s Quality of Life-brief—OPQOL-brief (Plummer et al. 2023)
Improving social dimension of life and reducing loneliness and isolation	- Social participation, network, support - Social role and relationship within community - Loneliness and isolation	- Social activity checklist (Fujiwara et al. 2009) - Amount of daily contact with people such as: relatives, co-workers, neighbours, and others. Frequency of contact (Fujiwara et al. 2009) - Social support scale (Fujiwara et al. 2009) - Social role in the TMIG index of competence (Fujiwara et al. 2009) - Reported perception of satisfaction with social relationships (Rotenberg-Shpigelman and Maeir 2011) - Participative observation and interview to Investigation of social cohesion/sense of community, relationship with others (Kristensen et al. 2023, Phil et al. 2024)
Slowing cognitive impairment	- Episodic/logical memory - Language capability (phonemic, semantic) - Intelligence - Executive functions - Spatio-temporal orientation	- Rivermead Behavioral Memory Test (RBMT) (Fujiwara et al. 2009, Sakurai et al. 2018) - Phonological and semantic verbal fluency tests (Fujiwara et al. 2009, Sakurai et al. 2018) - Semantic Fluency subtest (Plummer et al. 2023) - Japanese version of the Wechsler Adult Intelligence Scale-Revised (WAIS-R), Information, Picture Completion, and Digit Symbol (Fujiwara et al. 2009, Sakurai et al. 2018) - Mini-Mental State Examination (Sakurai et al. 2018, Juniarti et al. 2021, Murayama et al. 2015) - Logical Memory (LM) (Suzuki et al. 2014) - Test of Trail Making (TMT) (Sakurai et al. 2018, Suzuki et al. 2014) - Kana Test—KPT (Suzuki et al. 2014) - Montreal Cognitive Assessment—MOCA (Plummer et al. 2023)
Enhance functional aspects and physical functionality	- Functional and nutritional abilities - Physical performance	- TMIG Index of Competence (Fujiwara et al. 2009) - Activities of Daily Living (ADL) (Sakurai et al. 2018) - Instrumental ADL (IADL) (Sakurai et al. 2018) - Walking speed measurement (Fujiwara et al. 2009, Sakurai et al. 2018) - One-leg standing duration test (Fujiwara et al. 2009) - Hand grip strength test and finger pressure (Fujiwara et al. 2009, Sakurai et al. 2018) - Physical Activity Scale for the Elderly (PASE) (Juniarti et al. 2021)

Quality assessment tool

Two reviewers independently assessed the methodological quality of each included study and resolved any disagreement through discussion with a third researcher. Since the review included studies with differing or multiple methodologies, their quality was evaluated using the Mixed Methods Appraisal Tool (MMAT) (Pluye et al. 2009). The MMAT is a critical appraisal tool designed for systematic reviews of mixed studies, incorporating qualitative, quantitative, and mixed methods studies. It allows for the assessment of methodological quality across five study categories: qualitative research, randomized controlled trials, non-randomized studies, quantitative descriptive studies, and mixed methods studies. The first two questions on the checklist are the same for all study designs and assess whether the research questions are clearly stated and whether the collected data allow for answering them. For each study type, reviewers answer five different questions based on the corresponding study design, with possible responses being: ‘Yes’, ‘No’, and ‘can’t tell’. The current 2018 version was developed on the basis of findings from a literature review of critical appraisal tools, interviews with MMAT users, and an eDelphi study with international experts (Hong et al., 2018). The score obtained from the quality assessment tool is not a criterion for excluding a study from the review.

RESULTS

Studies characteristics

A total of 75 articles were analysed, of which 64 were excluded for various reasons: 12 involved an individual reading intervention, 6 targeted populations younger than 60, 7 had structured interventions other than reading groups, 9 were conducted in nursing or long-term care settings, and 29 were excluded for other reasons (such as language barriers or inability to retrieve the full-text). Refer to Fig. 1 for details.

Eleven papers met the established inclusion criteria and were subsequently selected for inclusion in the review (Table 1), providing a basis for the analysis and discussion of the findings. The studies varied in terms of the geographical areas where they were conducted. Four studies were carried out in Japan (Fujiwara et al. 2009, Suzuki et al. 2014, Murayama et al. 2015, Sakurai et al. 2018), one in Indonesia (Juniarti et al. 2021), two in Denmark (Kristensen et al. 2023, Phil et al. 2024), two in Israel (Rotenberg-Shpigelman and Maeir 2011, Harel and Ayalon 2022), one in Canada (Fiocco et al. 2019), and one in USA (Plummer et al. 2023). These studies, conducted between 2009 and 2023, employed various research designs: three used an experimental approach with pre- and post-intervention evaluation in non-randomized groups (Fujiwara et al. 2009, Murayama et al. 2015, Sakurai et al. 2018), four adopted qualitative methodologies (Rotenberg-Shpigelman and Maeir 2011, Harel and Ayalon 2022, Kristensen et al. 2023, Phil et al. 2024), two were randomized controlled trials (RCTs) (Suzuki et al. 2014, Juniarti et al. 2021), and two used a mixed methods approach (Fiocco et al. 2019, Plummer et al. 2023).

A total of 775 participants were included across the 11 studies, with the number of participants per study ranging from 5 to 177. The studies included community-dwelling older adults, older individuals with cognitive impairment (Rotenberg-Shpigelman and Maeir 2011, Juniarti et al. 2021), men who are nearing retirement or already retired (Kristensen et al. 2023, Phil et al. 2024), and one study focused on individuals living in Continuing Care Retirement Communities (CCRCs) (Harel and Ayalon 2022). The duration of interventions and the timing of participant assessments after the intervention varied widely across studies, ranging from 8 weeks (Fiocco et al. 2019, Harel and Ayalon 2022, Plummer et al. 2023, Phil et al. 2024) to a 6-year follow-up (Sakurai et al. 2018).

The studies varied in terms of intervention modalities, measured outcomes, and instruments used. All the tools used in the initial and final phases of the intervention were included, but those used during the participant selection phase for inclusion in the study were not (Table 2).

Five studies focused on an intergenerational reading program (Fujiwara et al. 2009, Suzuki et al. 2014, Murayama et al. 2015, Sakurai et al. 2018, Plummer et al. 2023), with four of which referring to the REPRINTS program (Research of Productivity by Intergenerational Sympathy). This intergenerational program involves older adults reading picture books to kindergarten and elementary school children, with the aim of maintaining or improving cognitive and physical functions of older adults, while also fostering new social networks and intergenerational exchanges. One paper concerned an occupational therapy intervention (Rotenberg-Shpigelman and Maeir 2011). A recent article compared mindfulness meditation (Fiocco et al. 2019) with read-aloud activities; another study involved physical activity and reading interventions (Juniarti et al. 2021). Finally, a study focused on bibliotherapy (Harel and Ayalon 2022), and two others involved shared reading groups (Kristensen et al. 2023, Phil et al. 2024): these recent interventions refer to the Danish Shared Reading project ‘Read, Man!’, which has implemented reading groups across Denmark (Kristensen et al. 2023). The project focuses on older men aged 65–75, a group particularly vulnerable to mental health issues associated with retirement. This vulnerability is often due to increased risks of loneliness and a loss of meaning in daily life (Noh et al. 2019, Folker et al. 2021).

Outcomes analysis

Table 3 summarizes the outcomes categorizing them into four groups based on the objectives outlined in our research question. The same categories guide the present section of the results. The table specifies the outcome dimensions mentioned in the articles along with the qualitative or quantitative tools used to measure them. Specifically, seven studies measured the impact of reading activities on the outcome of ‘Promoting psychosocial well-being’ (Fujiwara et al. 2009, Rotenberg-Shpigelman and Maeir 2011, Murayama et al. 2015, Fiocco et al. 2019, Harel and Ayalon 2022, Kristensen et al. 2023, Plummer et al. 2023); four articles highlighted changes in the outcome ‘Improving social interaction’ (Fujiwara et al. 2009, Rotenberg-Shpigelman and Maeir 2011, Fiocco et al. 2019, Kristensen et al. 2023, Phil et al. 2024); and five of the selected articles included ‘Slowing cognitive impairment’ (Fujiwara et al. 2009, Suzuki et al. 2014, Sakurai et al. 2018, Juniarti et al. 2021, Plummer et al. 2023) among the outcomes, evaluating the impact of reading on cognitive functions. Finally, five studies measured outcomes related to ‘Enhancing functional aspects and physical functionality’, such as functional and nutritional abilities (Fujiwara et al. 2009, Sakurai et al. 2018) and physical performance (Fujiwara et al. 2009, Sakurai et al. 2018, Juniarti et al. 2021).

The first outcome—promoting/enhancing psychosocial health and well-being—covers several sub-themes: improving psychological and mental well-being, reducing depressive symptoms and stress perception, increasing level of self-esteem, strengthening the sense of coherence, competence, self-efficacy, and (also) acceptance of the aging process as well as coping mechanisms. Regarding studies on the Japanese REPRINTS program, one demonstrated a significant positive impact only on the perception of one’s own health status, which was better in the intervention group than in the control group over 21 months, but no impact on depressive symptoms (Fujiwara et al. 2009). Another study showed the effectiveness of the reading intervention on participants’ sense of meaningfulness, manageability, and comprehensibility. Significant indirect effects were found on depressive mood through the sense of meaningfulness, suggesting that enhancing meaningfulness may help reduce depressive symptoms (Murayama et al. 2015). Additionally, both the intervention group and the control group showed an increase in the sense of coherence over 3 years. Two studies, conducted through qualitative methodology also highlighted positive themes regarding well-being and mental health in terms of sense-making. They reported that the intervention fostered a ‘unique form of collective affective engagement and shared sense-making’ (Kristensen et al. 2023), as well as reliance on external support and the achievement of specific professional and educational goals in their daily lives. Regarding the reduction of stress perception, one study demonstrated the effectiveness of a reading intervention in managing stress, with results comparable to those of mindfulness, which equally showed positive results (Fiocco et al. 2019). Concerning the themes of acceptance of the aging process and coping with loss, it was demonstrated that shared reading could activate participants’ imagination, memories, and emotional world. This process allows participants not to be overwhelmed by emotions and enables them to appreciate the positive aspects of their condition (Harel and Ayalon 2022).

Additionally, a study using qualitative research methodology found less consistent results regarding the acquisition of internal strategies (memory and execution) and the modification of negative beliefs (Rotenberg-Shpigelman and Maeir 2011). A study showed non-statistically significant results in measures of quality of life and mood in intergenerational reading groups, which may be attributed to the participants’ good psychological health at baseline, characterized by low levels of depressive, anxious, and stressful symptoms (Plummer et al. 2023).

The second outcome concerns the improvement of the social dimension of life (including social participation, network, support, social role, and relationship within the community) as well as the reduction of loneliness and isolation. This outcome is analysed in five studies using six different tools. Regarding social participation, networks, and support, an intervention e from the REPRINTS program showed that positive statistically significant effects were maintained at 9 months of follow-up, with the observed differences gradually diminishing over the subsequent 12 months (Fujiwara et al. 2009). Other studies using qualitative research methodology explored social roles and relationships within the community and among its members (Rotenberg-Shpigelman and Maeir 2011, Harel and Ayalon 2022, Kristensen et al. 2023, Phil et al. 2024). These studies revealed themes linking reading to social connectivity, in particular the concept of ‘literary connectivity’, which refers to the power of shared reading in creating a sense of belonging, sharing, and identification within the group (Phil et al. 2024). Another study identified similar themes regarding satisfaction with social relationships (Rotenberg-Shpigelman and Maeir 2011).

The third outcome—slowing cognitive impairment—includes dimensions such as episodic memory, language capability, intelligence, executive functions, and spatial-temporal orientation. It is explored by five studies using various quantitative tools and a few qualitative methods. Positive statistically significant improvements in cognitive functions were observed, as measured by the Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MOCA), in both healthy individuals (Suzuki et al. 2014, Plummer et al. 2023) and older people with dementia (Juniarti et al. 2021). In these studies, physical exercises combined with reading aloud (conducted by trained health professionals) improved not only the cognitive function but also participants’ ability to engage in physical activity. Additionally, concerning language, results suggest no significant changes in verbal fluency both in terms of phonemic fluency (from baseline to 6-year follow-up) (Sakurai et al. 2018) and in semantic fluency (Plummer et al. 2023). Moreover, some dimensions did not show positive improvements, including MMSE (Sakurai et al. 2018), episodic memory (measured with the Japanese version of the Rivermead behavioral memory test) (Fujiwara et al. 2009), logical memory (Suzuki et al. 2014), intelligence (evaluated with the Wechsler Adult Intelligence Scale or WAIS Scale-Revised) (Sakurai et al. 2018), and semantic language (Fujiwara et al. 2009). However, one study (Sakurai et al. 2018) highlighted the positive impact of the intervention in decreasing hippocampal atrophy on MRI, which is considered a proxy for slowing cognitive decline.

Regarding functional and physical abilities, a statistically significant improvement was demonstrated in grip strength (Fujiwara et al. 2009) and on the PASE (Physical Activity Scale for Elderly) (Juniarti et al. 2021). However, the intervention did not significantly affect other dimensions, as measured by the Trail Making Test over the 6-year follow-up (Sakurai et al. 2018).

Methodological quality

Supplementary Table S3 (Supplementary File) provides a summary of the study quality according to the five components of the MMAT. A final score based on the criteria of the MMAT instrument is shown in Table 1. The results highlighted some variability in the quality of the studies included in the review. Three out of four studies using qualitative methodologies met high study quality standards according to the MMAT evaluation criteria (Harel and Ayalon 2022, Kristensen et al. 2023, Phil et al. 2024) (80%–100% quality criteria met), while one study (Rotenberg-Shpigelman and Maeir 2011) exhibited weaknesses (40% quality criteria met). The randomized trials demonstrated a good to medium quality, with 80%–60% of quality criteria met (Suzuki et al. 2014, Juniarti et al. 2021). The non-randomized studies all pertained to the intergenerational REPRINTS program. Two of the studies demonstrated high quality, meeting 100% of the considered criteria (Fujiwara et al. 2009, Murayama et al. 2015), while one study (Sakurai et al. 2018) showed medium quality (60% quality criteria met) due to numerous dropouts leading to incomplete outcome data. The assessments of the two mixed method studies ranged from high quality (100% quality criteria met) (Fiocco et al. 2019) to low quality (40% quality criteria met) (Plummer et al. 2023). The latter study had limitations in integrating qualitative and quantitative data, as well as in the overall interpretation of the results derived from this integration.

DISCUSSION

The review, conducted in accordance with PRISMA guidelines, was designed to evaluate whether shared reading groups are effective in enhancing psychological well-being and quality of life, social engagement, cognitive functions, and functional and physical abilities in community-dwelling older adults. Eleven studies met the inclusion criteria. They are heterogeneous in terms of: (i) investigated outcomes (promoting psychosocial well-being, improving social interaction, slowing cognitive impairment, and enhancing functional aspects and physical functionality); (ii) study design (RCT, non-randomized trial, case study, quasi-experimental, mixed methods, qualitative study, and explorative intervention study); (iii) geographical areas (Denmark, USA, Israel, Indonesia, Canada, and Japan); and (iv) population characteristics (older people who are living in their own homes, with no cognitive impairment diagnosis, and older adults with cognitive impairment).

The narrative analysis of the included studies highlighted the tools used to measure the impact of interventions on outcomes and the main results. Overall, our review emphasized the positive impact of reading groups on outcomes, albeit with varying levels of effectiveness reflecting different research methodologies and follow-up times.

Regarding psychological health and well-being, significant positive effects were observed in self-rated health (Fujiwara et al. 2009), sense of meaningfulness (Murayama et al. 2015), sense-making (Kristensen et al. 2023), utilization of external aid and strategy use (Rotenberg-Shpigelman and Maeir 2011), and a reduction in perceived stress (Fiocco et al. 2019). However, non-statistically significant results were found in measures of quality of life and mood (Plummer et al. 2023).

These results suggest that the participation of older people in group activity—both sports/physical activities (Tsuji et al. 2020) and other types of participatory leisure activities (Bone et al. 2022)—are associated with higher self-rated health and a decrease in depressive symptoms. The mechanisms of change triggered by such interventions seem to be related to both reading as a form of cognitive stimulation and group facilitation, resulting in improved communication skills. Studies indicate benefits for older adults in terms of well-being and perceived quality of life, including a reduction in feelings of loneliness and an increase in social involvement and interaction (Tsang et al. 2013, Billington et al. 2019, DeVries et al. 2019). In the latter study, qigong was found to be effective in improving psychosocial functioning, with the reading activity serving as a control group.

Regarding the social dimension, positive effects have been demonstrated in social participation, networks, and support (Fujiwara et al. 2009), as well as in social roles and relationships within the community (Kristensen et al. 2023, Phil et al. 2024). Additionally, shared reading was reported to have a positive impact on the perceived satisfaction with social relationships (Rotenberg-Shpigelman and Maeir 2011). This aligns with a systematic review that showed the positive impact on social dimension outcomes and various aspects of quality of life (physical, mental, cognitive, and social) from both physical and cognitive group interventions, with the primary outcome of slowing the progression of functional and cognitive impairment (Gonnord et al. 2023). Indeed, the relationship between participation in social activity and the reduction of depressive symptoms is well-established (Chiao et al. 2011), as is the association between social participation and a reduced risk of developing dementia (Sommerlad et al. 2023) or slowing its progression. Subjective health status, social relationships, and interactions with neighbours and children have been identified as factors related to life satisfaction among older adults (Shen et al. 2023), with social interactions playing a crucial role (Diener et al. 2018). For these reasons, encouraging and promoting group interventions for this population is a public priority, as it promotes well-being, health, and overall life satisfaction.

With respect to cognitive functions, significant improvements have been reported in executive functions and attention (Suzuki et al. 2014) among healthy individuals, and in overall cognitive functions for individuals with dementia (Juniarti et al. 2021). Reading and literacy activities in general show positive effects in preventing and slowing cognitive decline in older adults (Raichlen et al. 2022, Stine-Morrow et al. 2022, Wu et al. 2023).

The outcomes without statistically significant results are as follows: MMSE (Sakurai et al. 2018); language (Fujiwara et al. 2009, Sakurai et al. 2018, Plummer et al. 2023); and episodic memory, measured with the Japanese version of the Rivermead behavioral memory test (Fujiwara et al. 2009), logical memory (Suzuki et al. 2014), intelligence evaluated with the WAIS Scale-Revised (Sakurai et al. 2018), and physical ability measured with trail making test (Sakurai et al. 2018).

Finally, an analysis of the results highlights the added value of reading and using literary texts in a group setting. This approach makes it possible to deal with many different topics, including those not directly related to the participants’ current life situations, while introducing different kinds of reflections, increasing awareness and presence, giving meaning and social connectedness (Kristensen et al. 2023). Moreover, literary texts seem particularly well-suited in fostering social interaction based on identification. Firstly, their linguistic nature is easily translated into the flow of human interaction and communication that largely constructs society; secondly, they provide access to the inner thoughts and feelings of the characters in the texts, facilitating reflection on one’s own (Phil et al. 2024). Indeed, the literary elements contribute to facilitating the establishment of an ‘aesthetic distance’ between the participants and the literary works, as highlighted in the Israeli study (Harel and Ayalon 2022). Through metaphors, images, and intertextuality or symbols, the participants can establish a connection with the texts without being emotionally overwhelmed by their feelings. In accordance with the tenets of reader response theory (Iser 1972), the literary elements appear to stimulate imagination, evoke memories, and engage the emotional realm of the participants. The beneficial effects of reading that emerged from the studies included are in line with other studies investigating the added value of reading on various living conditions in the older population (Chang et al. 2021) but also in other target groups, such as developmental age subjects (Lucas et al., 2019), young people (University of Liverpool 2019, Franz et al. 2022, Sun et al. 2024), and adults (Gualano et al. 2017).

As mentioned above, if activities are conducted in a group setting, the benefits also extend to the socialization dimensions discussed previously. This evidence aligns with the latest recommendations for promoting well-being in older adults and slowing the progression of frailty. The WHO Commission on Integrated Care for Older People (ICOPE) has developed guidelines that emphasize optimizing intrinsic and functional capacity as key components of successful ageing. The ICOPE program advocates for a primary care-centred approach, with a long-term focus, integrating communities, healthcare and social services, various professionals, and families. It underscores the importance of proactive frailty management to prevent disability. The multi-component interventions proposed by the ICOPE program address different frailty domains, promoting well-being and reducing frailty and disability progression (Araujo de Carvalho et al. 2017, WHO 2017, Tavassoli et al. 2021). A study specifically examined the effectiveness of combined sports and reading interventions in slowing frailty progression (Gallucci et al. 2020). The study involved a group program for older individuals with mild cognitive impairment and confirmed the beneficial effects of physical activity and reading in preventing frailty progression in this population.

Limitations and strengths

The primary studies included in the review show differences in terms of tools and methods, resulting in diverse perspectives. However, this diversity also presents challenges, as the fragmentation of results makes synthesis and comparison difficult. Additionally, many studies are based on a few repeated experiences; for instance, the Japanese REPRINTS program is represented in four articles. Limitations in some studies include the different timing of test scores, while others fail to clearly specify the instruments used or even apply different ones across separate time intervals. Moreover, even though qualitative studies offer valuable insights, they do not assess the strength of associations or the maintenance of findings over time. Nevertheless, they play a crucial role in guiding future studies that use different research methodologies, potentially leading to more statistically robust results. The decision to include all types of research designs and disciplines was driven by the limited number of studies on the intervention of interest and the aim to explore the topic comprehensively.

In addition to these limitations, the heterogeneity in study quality—low in some cases—represents a significant challenge for synthesizing the findings and could undermine the accuracy of conclusions. These challenges are exacerbated by inconsistencies in the reporting of tools and outcomes across studies, with some elements not fully detailed in the results sections. As a result, drawing definitive conclusions or identifying patterns of effectiveness is difficult, even though the studies generally show a positive impact.

Despite these limitations, this study has numerous strengths. To the best of our knowledge, it represents the first systematic review on this specific type of intervention, highlighting a promising and unexplored area.

Given the importance of promoting the well-being of older adults in public health, there is a growing need to strengthen the evidence for group interventions in this population. Shared reading groups, although relatively recent, are a promising example of promoting psychological health and well-being, improving the social dimension of life (including social participation, networks, support, social roles, and community relationships), reducing loneliness and isolation, slowing cognitive decline, and maintaining functional and physical abilities. We recommend further primary studies, not only to identify elements of effectiveness but also to facilitate the design of implementation research processes, focusing on the factors that influence both the implementation process and its outcomes.

CONCLUSIONS

Active aging has become progressively more relevant in contemporary society. In addition to extending lifespan, it is essential for both current and future generations to enhance the quality of those years by addressing issues such as disability, loss of autonomy, and loneliness, which often characterize the later years of life. In this context, all the interventions aimed at promoting psychosocial health and well-being and social participation appear to be key in containing anxiety, depression, sense of emptiness, and defeat, as well as the loss of a defined social role, factors that often precede cognitive decline. So, the implementation of non-pharmacological interventions aimed at safeguarding people’s health and well-being become a key component of a strategy to maintain older persons’ health shared reading, which does not require technology or expensive devices, can be considered a ‘democratic’ healthy choice for all. As affirmed by Arthur Schopenhauer, ‘Health is not everything, but without health, everything is nothing’. Health remains the most important element in building a successful strategy for serenity, well-being, and, perhaps, happiness at all ages. If shared reading can bring even a shred of happiness to older people, it will have achieved its purpose.

AUTHOR CONTRIBUTIONS

C.M., C.L., and G.B. defined the idea of the study. All authors contributed to the conception and design of the study. C.M., C.B., E.P., and C.R. conducted the literature search, assessed the quality and risk of bias of the included studies, and performed data extraction and analysis. All authors contributed to writing and editing the manuscript, reviewed and provided critical feedback on the manuscript drafts, and approved the final version to be published.

CONFLICT OF INTEREST

The author declares that no conflicts of interest exist in relation to the present article.

FUNDING

We acknowledge co-funding from Next Generation EU, in the context of the National Recovery and Resilience Plan, Investment PE8—Project Age-It: ‘Ageing Well in an Ageing Society’. This resource was co-financed by the Next Generation EU [DM 1557 11.10.2022]. The views and opinions expressed are only those of the authors and do not necessarily reflect those of the European Union or the European Commission. Neither the European Union nor the European Commission can be held responsible for them. We also acknowledge co-funding from Tuscany region project entitled ‘Da Casa della Salute a Casa della Comunità’ (DGRT n.1125/2021). The project was approved following ‘Linee di indirizzo per la realizzazione dei progetti regionali sulla sperimentazione di strutture di prossimità’, Annex 1 to the ‘Intesa tra il Governo, le Regioni e le Province autonome di Trento e Bolzano, Rep. Atti n. 134/CSR del 4 agosto 2021’. The views and opinions expressed are only those of the authors and do not necessarily reflect those of the Tuscany Region or the Italian Government. Neither the Tuscany Region nor the Italian Government can be held responsible for them.

DATA AVAILABILITY

The data underlying this article are available in the article and in its online supplementary material.

ETHICS APPROVAL

This systematic review does not require ethical approval, as it does not involve the collection of primary data. The protocol has not been registered in the International Prospective Registry of Systematic Reviews.