Social isolation and loneliness are known to be important risk factors for cardiovascular disease, but much is unknown about their specific relationship to heart failure. Now, a new study published in “JACC: Heart” shows that both social isolation and loneliness are associated with higher rates of heart failure, but that whether or not a person feels lonely is more important in determining that risk than being really alone.
Social disconnection can be categorized into two different but related components. The “Social isolation«refers to being objectively alone or having infrequent social connections, while the «soledad« is defined as a painful feeling caused when someone’s actual level of social interaction is less than they would like.
For the study, the 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 using self-reported questionnaires.
The health outcomes of a population of more than 400,000 middle-aged and older adults were reviewed. According to Jihui Zhangresearcher of the Guangzhou Medical University (China) and lead author of the study, previous studies have been inconclusive, have produced conflicting results, and have used different measures to assess social isolation and loneliness.
The work revealed that both social isolation and loneliness increased the risk of hospitalization or death from heart failure by between 15% and 20%. However, it was also appreciated that social isolation was only a risk factor when loneliness was not also present. In other words, if a person was socially isolated and lonely at the same time, loneliness was more important.
Loneliness also increased risk even if the person was not socially isolated. Loneliness and social isolation were more frequent in men and were also associated with adverse behaviors and health states, such as tobacco use and obesity.
Social isolation and loneliness increase the risk of hospitalization or death from heart failure by 15% to 20%
One reason for these findings could be that people can feel lonely even when they are in relationships or interacting with other peopledetails Zhang.
“These findings indicate that the impact of subjective loneliness was more important than that of objective social isolation,” he says.
In his opinion, the results “suggest that when loneliness is present, social isolation is not more important in relation to heart failure. Loneliness is likely to be a stronger psychological stressor than social isolation, because loneliness is common in hostile individuals or with stressful social relationships.”
According to Zhang, the study does not point to the need for effective tools to detect social isolation and loneliness in clinical care, but also to the importance of distinguishing between these two factors.
The findings are especially relevant, as the pandemic of covid-19 has highlighted the impact of social isolation and loneliness on a wide range of health outcomes, he says.