Social isolation and loneliness may be associated with death, AMI and stroke

Social isolation and loneliness may be associated with death, AMI and stroke

Socially isolated or lonely people are at increased risk of acute myocardial infarction (AMI), stroke and death, regardless of other factors, concludes the study. American Heart Association (AHA) in a new scientific statement.

More than four decades of research “have clearly demonstrated that social isolation and loneliness are associated with adverse health outcomes,” Dr. Crystal Wiley Cene, from University of California San DiegoHealthin the United States.

“Given the prevalence of social disconnection in the US, the public health impact is quite significant,” added Dr. Crystal.

The writing group reported that more research is needed to design, implement, and test interventions to improve the cardiovascular and brain health of socially isolated or lonely people.

The scientific statement was published online on August 4 in the journal Journal of the American Heart Association.

Common and potentially fatal

Social isolation is defined by infrequent personal contact with other people, and loneliness occurs when a person feels alone or connects less than they would like with other individuals.

An estimated one-quarter of community Americans aged 65 and over are socially isolated, and even more seniors are lonely.

However, the problem is not restricted to the elderly. Research suggests that younger adults also suffer from social isolation and loneliness, which can be attributed to greater use of social media and less frequent in-person activities.

Dr. Crystal and colleagues reviewed observational and experimental studies on social isolation published through July 2021 to analyze the impact of social isolation and loneliness on cardiovascular and brain health.

Evidence consistently points to a direct association between social isolation, loneliness, and death from coronary artery disease (CAD) and stroke, the researchers reported.

For example, a meta-analysis of 19 studies showed that social isolation and loneliness increase the risk of CAD by 29%. Most of these studies focused on AMI and/or death from CAD as a measure of CAD.

A meta-analysis of eight longitudinal observational studies showed that social isolation and loneliness were associated with a 32% increase in stroke risk, after adjusting for age, sex, and socioeconomic status.

The literature also suggests that social isolation and loneliness are associated with worse prognoses in adults with established CAD or a history of stroke.

A systematic review showed that socially isolated people with CAD had a two- to three-fold increased risk of disease and death at six years, regardless of cardiac risk factors.

Other research has suggested that socially isolated adults with fewer than four social contacts per month are at a 40% higher risk of recurrent stroke or AMI.

There is less robust data on the association of social isolation and loneliness with heart failure (HF), dementia and cognitive impairment, according to the writing group.

It’s also unclear whether being isolated (social isolation) or feeling isolated (loneliness) is more important for cardiovascular and brain health, as only a few studies have examined both in the same sample, the researchers point out.

However, a study published in the journal neurology in June this year showed that seniors who reported feeling socially isolated had worse cognitive function at baseline than those who did not report social isolation and were 26% more likely to have dementia in the follow-up period, as reported by Medscape.

Urgent need for interventions

“There is an urgent need to design, implement and evaluate programs and strategies to reduce the negative effects of social isolation and loneliness on cardiovascular and brain health, particularly in at-risk populations,” said Dr. Crystal in the press release.

She encourages clinicians to ask patients about their social life and whether they are satisfied with their level of interaction with friends and family, and to be prepared to refer socially isolated or lonely patients, especially those with a history of CAD or stroke, to services. communities to help them connect with others.

Exercise programs and recreational activities in senior centers, as well as interventions that address negative self-esteem and other negative thoughts, have shown promise in reducing isolation and loneliness, according to the writing group.

This scientific statement was prepared by a voluntary writing group on behalf of the following institutions: o AHA Social Determinants of Health Committee and the Prevention Science Committeeof Council on Epidemiology and Prevention It’s from Council on Quality of Care and Outcomes Research; O Prevention Science Committee of Council on Epidemiology and Prevention It’s from Council on Cardiovascular and Stroke Nursing; O Council on Arteriosclerosis, Thrombosis and Vascular Biology; it’s the Stroke Council.

This research has not received commercial funding. Members of the writing group reported no relevant conflicts of interest.

J Am Heart Assoc. Published online on August 4, 2022. Full text

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