Social isolation and loneliness increase risk of heart failure
Studies have shown that social isolation and loneliness are important risk factors for cardiovascular disease, but less is known about their specific connection to heart failure. A new study published in JACC: Heart Failure shows that both social isolation and loneliness are associated with higher rates of heart failure, but whether or not a person feels lonely is more important in determining risk than whether they are actually lonely.
Social disconnection can be classified into two different, but connected, components. " Social isolation" refers to being objectively alone or having infrequent social connections, while "loneliness" is defined as a painful feeling caused when someone’s actual level of social interaction is less than they would like it to be.
For the study, researchers analyzed data from the UK Biobank study, which followed population health outcomes for 12 years and assessed psychosocial factors such as social isolation and loneliness through self-reported questionnaires. The researchers analyzed the health outcomes of a population of more than 400,000 middle-aged and older adults . Previous studies have been inconclusive, with inconsistent results, and have used different measures to assess social isolation and loneliness, said Jihui Zhang, MD, PhD, a researcher at Guangzhou Medical University in Guangzhou, China, and lead author of the study. .
The researchers found that both social isolation and loneliness increased the risk of hospitalization or death from heart failure by 15% to 20%. However, they also found that social isolation was only a risk factor when loneliness was not also present. In other words, if a person was socially isolated and felt lonely, loneliness was more important . Loneliness also increased the risk even if the person was not socially isolated. Loneliness and social isolation were more common in men and were also associated with adverse behaviors and health states, such as tobacco use and obesity.
One reason for these findings could be that people can feel lonely even when they are in a relationship or interacting with others, Zhang said.
“These findings indicate that the impact of subjective loneliness was more important than that of objective social isolation,” he said. “These results suggest that when loneliness is present, social isolation is not more important in relation to heart failure. “Loneliness is probably a stronger psychological stressor than social isolation because loneliness is common in people who are hostile or have stressful social relationships.”
Zhang said the study pointed to the need for effective tools to screen for social isolation and loneliness in routine clinical care and a broader push to provide more social support. She also indicates the importance of distinguishing between these two factors.
“We will pay more attention to those people who feel alone because of the intervention,” he said. “For people who don’t feel alone, we will evaluate social isolation.” The findings are especially relevant as the COVID-19 pandemic has highlighted the impacts of social isolation and loneliness on a wide range of health outcomes, she said.
In a related editorial comment, Sarah J. Goodlin, MD, researcher at Patient-Centered Education and Research, and Sheldon Gottlieb, MD, associate professor of medicine at Johns Hopkins University School of Medicine, said that social isolation and Loneliness is often affected by an individual’s socioeconomic status .
“The relationship with social isolation and loneliness is likely stronger in people at the extremes of social isolation and loneliness, and is compounded by low socioeconomic status,” Goodlin and Gottlieb said. “As social determinants of health are increasingly recognized as important components of patient-centered healthcare, it may be appropriate to incorporate targeted interventions such as ’social prescribing’ into care.”
For future studies, the researchers plan to investigate the impacts of social isolation and loneliness on major health outcomes in vulnerable populations, including patients with type 2 diabetes, and are also working on experimental studies to better understand the mechanisms through which social isolation and loneliness affect the health of the cardiovascular system.
Social isolation is related to the classic risk factors for dementia related to Alzheimer’s disease
Study finds new association between social isolation and dementia risk factors
Researchers used data from more than half a million people in the United Kingdom and Canada to discover a link between social capital and indicators of Alzheimer’s disease-related dementia.
Social lifestyle determinants, including social isolation, are associated with risk factors for neurodegeneration , according to a new study published this week in the open access journal PLOS ONE by Kimia Shafighi of McGill University, Canada, and colleagues. .
Alzheimer’s disease and related dementias (ADRD) is a growing public health crisis, with an annual global cost of more than $1 trillion US dollars. There is increasing evidence that social isolation is associated with increased risk of ADRD, but the links between social lifestyle and other known risk factors for ADRD are less known.
In the new work, the researchers studied data from 502,506 UK Biobank participants and 30,097 people enrolled in the Canadian Longitudinal Study of Aging. Both studies had questionnaires that included questions about loneliness, frequency of social interaction, and social support.
The study found a wide variety of associations between potentially modifiable ADRD risk factors and loneliness and lack of social support. People who smoked more, drank alcohol excessively, experienced sleep disturbances, and did not frequently participate in light or vigorous physical activity (all known risk factors for ADRD) were more likely to feel lonely and lacking social support. For example, in CLSA, greater regular participation in physical exercise with others was associated with a 20.1% decrease in the odds of feeling lonely and a 26.9% decrease in having poor social support.
Physical and mental health factors previously linked to ADRD, such as cardiovascular disease, visual or hearing impairment, diabetes, and neurotic and depressive behaviors, were also associated with both subjective and objective social isolation. In the UKBB, for example, difficulty hearing in background noise corresponded to a 29.0% increase in the odds of feeling lonely and a 9.86% increase in the odds of lacking social support. The odds of feeling lonely and lacking social support were also 3.7 and 1.4 times higher, respectively, based on a participant’s neuroticism score.
The authors conclude that social isolation, which can be more easily modified than underlying or genetic health risk factors, could be a promising target for preventive clinical action and policy interventions.
The authors add: "Given the uncertain impact of social distancing measures imposed by COVID-19, our findings underscore the importance of investigating the multiscale effect of social isolation to inform public health interventions for ADRD."
