Loneliness and social isolation among older women can increase heart disease risk by as much as 27%, according to a UC San Diego-led study published Wednesday.
The findings of the study, published in Wednesday's online issue of JAMA Network Open, reveal that social isolation and loneliness independently increased cardiovascular disease risk by 8% and 5%, respectively. However, if women experienced high levels of both, their risk rose 13% to 27% compared to women who reported low levels of social isolation and low levels of loneliness.
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"We are social beings. In this time of COVID-19, many people are experiencing social isolation and loneliness, which may spiral into chronic states," said first author Natalie Golaszewski, a postdoctoral scholar at the Herbert Wertheim School of Public Health and Human Longevity Science at UCSD. "It is important to further understand the acute and long-term effects these experiences have on cardiovascular health and overall well-being."
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According to the researchers, social isolation and loneliness are mildly correlated and can occur at the same time, but are not mutually exclusive. A socially isolated person is not always lonely and conversely a person experiencing loneliness is not necessarily socially isolated.
"Social isolation is about physically being away from people, like not touching or seeing or talking to other people," said senior author John Bellettier assistant professor of epidemiology at the Wertheim School. "Loneliness is a feeling, one that can be experienced even by people who are regularly in contact with others."
Compounding the issue is the fact that social isolation and loneliness are associated with health conditions that increase the risk of heart disease including obesity, smoking, physical inactivity, poor diet, high blood pressure and high cholesterol.
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When researchers included all of these factors in their study and adjusted for diabetes and depression, high social isolation and loneliness remained strongly linked with increased risk for heart disease.
According to the U.S. Centers for Disease Control and Prevention, heart disease is the leading cause of death for women in the United States, responsible for one in every five deaths.
A quarter of adults 65 and older report social isolation and a third of adults 45 or older report being lonely.
"We do not yet know whether the increased risk of cardiovascular disease is due to acute exposure to social isolation and loneliness or whether prolonged exposure accumulated over a lifetime is the culprit. Further studies are needed to better understand that," Bellettiere said.
According to previous research, women tend to experience more social isolation than men.
For the UCSD study, 57,825 postmenopausal women living in the United States were sent a questionnaire assessing loneliness and social support in 2014 to 2015.
The participants were followed through 2019 or when they were diagnosed with heart disease, which affected 1,599 of them.
"Measures of social isolation and loneliness -- even with brief questions as was done in our study -- should be incorporated into standard care," said Golaszewski. "We monitor our patients' blood pressure, weight and temperature, and it might also be beneficial to capture the social needs that individuals may be lacking to better understand cardiovascular risk and develop solutions."
