by Studies have shown that social isolation and loneliness are important risk factors for cardiovascular disease, but less is known about their specific link with 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 a person feels alone is more important in determining risk than whether they are truly alone.
Social disconnection can be classified as two distinct, but connected, components. “Social isolation” refers to being objectively alone or having sparse social connections, while “loneliness” is defined as a painful feeling that occurs when one’s actual level of social interaction is less than they would like it to be.
For the study, the researchers looked at data from the UK Biobank study, which tracked population health outcomes for 12 years and assessed psychosocial factors such as social isolation and loneliness through self-reported questionnaires. Researchers looked at the health outcomes of a population of more than 400,000 middle-aged and older adults. D., a researcher at Guangzhou Medical University in Guangzhou, China, and senior author of the study.
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 is a risk factor only when loneliness is not present. In other words, loneliness was more important if a person felt both socially isolated and lonely. Loneliness increased the risk even if the person was not socially isolated. Loneliness and social isolation were more common in males and were also associated with negative health behaviors and status, such as tobacco use and obesity.
One reason for these findings may be that people feel lonely even when they are in relationships or interacting with others, Zhang said.
“These findings suggest that the effect of subjective loneliness is more significant than objective social isolation,” he said. “These results suggest that when loneliness is present, social isolation is no more important in connecting with heart failure. Loneliness is probably a stronger psychological stressor than social isolation because loneliness is common in people who act hostile or have stressful social relationships.”
Zhang said the study points to the need for effective tools to screen for social isolation and loneliness in routine clinical care, and the need for broader pressure to provide greater social support. It also demonstrates the importance of distinguishing between these two factors.
We will pay more attention to individuals who feel lonely for the intervention,” he said. “We will screen for social isolation for individuals who do not feel lonely.”
The findings are particularly relevant as the COVID-19 pandemic highlights the effects of social isolation and loneliness on a wide range of health outcomes.
In a related editorial comment, Sarah J. Goodlin, MD, a researcher at Patient-Centered Education and Research, and Sheldon Gottlieb, MD, a professor of medicine at the Johns Hopkins University School of Medicine, said that social isolation and loneliness are often affected by an illness. socioeconomic status of the individual.
Goodlin and Gottlieb conclude, “The association with social isolation and loneliness is probably strongest in people at the extremes of social isolation and loneliness and in people combined with low socioeconomic status.” Said. “As social determinants of health are increasingly recognized as important components of patient-centered health care, it may be appropriate to incorporate certain interventions into care, such as ‘social prescribing’.”
For future studies, the researchers plan to investigate the effects of social isolation and loneliness on important health outcomes in vulnerable populations, including patients with Type 2 diabetes, and are also working on experimental studies to better understand the mechanisms by which social isolation and loneliness affect the cardiovascular system. health.
