Social isolation and loneliness increase the risk of death from heart attack, stroke

August 21, 2022

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Social isolation and loneliness increase the risk of death from heart attack, stroke

Social isolation and loneliness are associated with about a 30% increased risk of heart attack or stroke, or death from either, according to a new scientific statement from the American Heart Association, published in the Journal of the American Heart Association. The statement also identifies the lack of data on interventions that may improve cardiovascular health for people who are socially isolated or lonely.

What the researchers say: “Over four decades of research has clearly demonstrated that social isolation and loneliness are both associated with adverse health outcomes,” said the lead writer of the statement. “Given the prevalence of social disconnectedness across the U.S., the public health impact is quite significant.”

The risk of social isolation increases with age due to life factors, such as widowhood and retirement. Nearly one-quarter of U.S. adults ages 65 and older are socially isolated, and the prevalence of loneliness is even higher, with estimates of 22% to 47%. However, younger adults also experience social isolation and loneliness. A survey from Harvard University’s Making Caring Common project describes “Gen Z” (adults currently aged 18-22) as the loneliest generation. Increased isolation and loneliness among younger adults may be attributed to higher social media use and less engagement in meaningful in-person activities.

Data also suggests that social isolation and loneliness may have increased during the COVID-19 pandemic, particularly among young adults ages 18-25, older adults, women, and low-income individuals.

Social isolation is defined as having infrequent in-person contact with people for social relationships, such as with family, friends, or members of the same community or religious group. Loneliness is when you feel like you are alone or have less connection with others than you desire. “Although social isolation and feeling lonely are related, they are not the same thing,” the writers explain. “Individuals can lead a relatively isolated life and not feel lonely, and conversely, people with many social contacts may still experience loneliness.”

The writing group reviewed research on social isolation published through July 2021 to examine the relationship between social isolation and cardiovascular and brain health. They found:

  • Social isolation and loneliness are common, yet under-recognized determinants of cardiovascular and brain health.
  • Lack of social connection is associated with an increased risk of premature death from all causes, especially among men.
  • Isolation and loneliness are associated with elevated inflammatory markers, and individuals who were less socially connected were more likely to experience physiological symptoms of chronic stress.
  • In assessing risk factors for social isolation, the relationship between social isolation and its risk factors goes both ways: depression may lead to social isolation, and social isolation may increase the likelihood of experiencing depression.
  • Social isolation during childhood is associated with increased cardiovascular risk factors in adulthood, such as obesity, high blood pressure, and increased blood glucose levels.
  • Socio-environmental factors, including transportation, living arrangements, dissatisfaction with family relationships, the pandemic, and natural disasters, are also factors that affect social connections.

Evidence is most consistent for a link between social isolation, loneliness, and death from heart disease and stroke, with a 29% increase in the risk of heart attack and/or heart disease death, and a 32% increased risk of stroke and stroke death. “Social isolation and loneliness are also associated with worse prognosis in individuals who already have coronary heart disease or stroke,” the authors added.

People with heart disease who were socially isolated had a two- to three-fold increase in death during a six-year follow-up study. Socially isolated adults with three or fewer social contacts per month may have a 40% increased risk of recurrent stroke or heart attack. In addition, 5-year heart failure survival rates were lower (60%) for people who were socially isolated, and for those who are both socially isolated and clinically depressed (62%), compared to those who have more social contacts and are not depressed (79%).

Social isolation and loneliness are also associated with behaviors that negatively impact cardiovascular and brain health, such as lower levels of self-reported physical activity, less fruit and vegetable intake, and more sedentary time. Multiple large studies found significant associations between loneliness and a higher likelihood of smoking.

“There is an urgent need to develop, implement and evaluate programs and strategies to reduce the negative effects of social isolation and loneliness on cardiovascular and brain health, particularly for at-risk populations,” said the lead author. “Clinicians should ask patients about the frequency of their social activity and whether they are satisfied with their level of interactions with friends and family. They should then be prepared to refer people who are socially isolated or lonely — especially those with a history of heart disease or stroke — to community resources to help them connect with others.”

Surprisingly, the review did not identify any research aimed at reducing social isolation with the specific goal of improving cardiovascular health.

“It is unclear whether actually being isolated (social isolation) or feeling isolated (loneliness) matters most for cardiovascular and brain health because only a few studies have examined both in the same sample,” the writers said. “More research is needed to examine the associations among social isolation, loneliness, coronary heart disease, stroke, dementia, and cognitive impairment, and to better understand the mechanisms by which social isolation and loneliness influence cardiovascular and brain health outcomes.”

So, what? Over the years I have reported many studies that have pointed out the dangers of social isolation and loneliness. Not long ago a study showed that just 48 hours without meaningful social contact starts several cognitive processes which prepare the brain for death.

The tragedy of our present age is that it is in the interests of politicians, social media outlets, and other actors to promote our feelings of isolation to enable them to be better able to sell us their products or even their deranged conspiracies. An isolated, lonely person is disempowered and their desperation makes them more open to accepting anything that seems to promote relief.

Dr Bob Murray

Bob Murray, MBA, PhD (Clinical Psychology), is an internationally recognised expert in strategy, leadership, influencing, human motivation and behavioural change.

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