Highlights of the announcement:
Social isolation and loneliness are common in the United States, and they have detrimental effects on heart and brain health.
Older people and people from socially vulnerable groups, such as people from disadvantaged racial or ethnic groups, people with disabilities or members of gender or sexual minority groups, may be at greater risk of social isolation and loneliness.
The data also suggests that social isolation and loneliness may increase among many groups during the COVID-19 pandemic.
More research is needed to develop and implement public health interventions to reduce the negative effects of social isolation and loneliness on cardiovascular health.
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(NewMediaWire) – August 04, 2022 – DALLAS Social isolation and loneliness are associated with a 30% increased risk of heart attack or stroke or death, according to a new scientific statement from the American Heart Association. Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association. The report also identified a lack of data on interventions that may improve cardiovascular health for people who are socially isolated or lonely.
“More than four years of research has clearly shown that social isolation and loneliness have negative health effects,” said Crystal Wiley Sen, MD, MPH, FAHA, scientific statement group chair, professor of clinical medicine, and chief investigator. Administrative Officer for Health Equity, Diversity and Inclusion at University of California San Diego Health. “Given the prevalence of social exclusion in the United States, the public health implications are significant.”
With age, the risk of social isolation increases due to lifestyle factors such as widowhood and retirement. Nearly a quarter of US adults age 65 and older are socially isolated, and the prevalence of loneliness is even higher, ranging from about 22% to 47%. However, young people also experience social isolation and loneliness. A survey by Harvard University’s Making Caring Common Project described Gen Z (adults currently aged 18-22) as the loneliest generation. Increased isolation and loneliness among youth may be related to greater use of social media and less participation in personal activities.
The data also show that social isolation and loneliness may increase during the COVID-19 pandemic, particularly among young people aged 18-25, older people, women and low-income people.
Social isolation is defined as infrequent personal contact with people for social relationships, such as family, friends, or members of the same community or religious group. Loneliness is when you feel alone or less connected to others than you would like. “While social isolation and loneliness are related, they are not the same thing,” explains Sen. “People can live relatively isolated lives and not feel lonely, whereas people with lots of social connections can still feel lonely.”
The writing team reviewed research on social isolation published up to July 2021 and examined the relationship between social isolation and cardiovascular and brain health. They found:
Social isolation and loneliness are common but underrecognized determinants of cardiovascular and brain health.
Lack of social contact is associated with an increased risk of premature death from all causes, especially among men.
Loneliness and isolation are associated with increased inflammatory markers, and those who are less socially connected experience physiological symptoms of chronic stress.
When assessing risk factors for social isolation, the relationship between social isolation and its risk factors is bidirectional: depression can lead to social isolation, and social isolation increases the likelihood of depression.
Childhood social isolation is associated with increased cardiovascular risk factors in adulthood, such as obesity, high blood pressure, and elevated blood glucose levels.
Socio-environmental factors, including transportation, living conditions, dissatisfaction with family relationships, pandemics, and natural disasters are also factors that affect social connections.
“There is strong evidence linking social isolation and loneliness to poorer heart and brain health in general; however, data on associations with specific outcomes such as heart failure, dementia and cognitive impairment are sparse,” Cen said.
The evidence is most consistent for the association between social isolation, loneliness and death from heart disease and stroke, with a 29% increased risk of heart attack and/or death from heart disease and a 32% increased risk of death from stroke and stroke. “Social isolation and loneliness are associated with poor prognosis in people with coronary heart disease or stroke,” Tsen added.
People with heart disease who were socially isolated had a two- to three-fold increase in death during the six-year follow-up study. Socially isolated adults who have 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 for socially isolated individuals (60%) and socially isolated and clinically depressed (62%), compared to socially connected individuals. depression (79%).
Social isolation and loneliness are also associated with behaviors that negatively impact cardiovascular and brain health, such as low self-reported physical activity levels, low fruit and vegetable consumption, and sedentary time. Many large studies have found a significant correlation between loneliness and a higher likelihood of smoking.
“There is an urgent need to develop, implement, and evaluate programs and strategies to reduce the adverse effects of social isolation and loneliness on cardiovascular and cerebrovascular health, particularly among at-risk populations,” Tsen said. “Clinicians should ask patients about the frequency of their social activity and whether they are satisfied with their relationships with friends and family. Then they should be prepared to refer people who are socially isolated or lonely, especially those with heart disease, or help them connect with others. Tap into community resources to provide.”
Some populations are more likely to experience social isolation and loneliness, and social isolation is more common among these groups, including children and youth, racial and ethnic groups, lesbian, gay, bisexual, transgender and queer (LGBTQ) people, people with physical disabilities, hearing or vision impairments people, rural and under-resourced communities, people with limited access to technology and internet service, new immigrants and incarcerated people.
The review highlights research aimed at reducing social isolation and loneliness among older adults. These studies have shown that fitness programs and recreational activities in senior centers, as well as interventions aimed at addressing negative thoughts about self-esteem and other negative thinking, show promise in reducing isolation and loneliness.
The review identified no studies that focused on reducing social isolation with the specific aim of improving cardiovascular health.
“Whether isolation (social isolation) or isolation (loneliness) is truly more important for cardiovascular and brain health is unclear because only a few studies examined the same sample,” Tsen said. “More research is needed to examine the links between social isolation, loneliness, coronary heart disease, stroke, dementia and cognitive impairment, and to better understand how social isolation and loneliness affect cardiovascular and brain health outcomes.”
This scientific statement was prepared by a volunteer writing group on behalf of the American Heart Association’s Committee on Social Determinants of Health, Council on Epidemiology and Prevention, and Council on Care Quality and Outcomes Research; Council on Epidemiology and Prevention’s Prevention Science Committee and Council on Healthcare Quality and Outcomes Research; the Scientific Committee on Prevention of the Council on Epidemiology and Prevention and the Council on Cardiovascular and Stroke Nursing; advice on arteriosclerosis, thrombosis and vascular biology; and stroke counseling.
Scientific statements from the American Heart Association promote greater awareness of cardiovascular disease and stroke and facilitate informed health care decisions. Scientific reports indicate what is currently known about a topic and which areas need further research. Although scientific statements inform guideline development, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.
Co-authors – Vice Chair Theresa M. Becky, Ph.D., FAHA; Mario Sims, Ph.D., FAHA; Shakira F. Suglia, Sc.D., MS, FAHA; Brooke Aggarwal, Ed.D., MS, FAHA; Natalie Moise, MD; Monique C. Jimenez, SM, Sc.D., FAHA; Bamba Gaye, PhD; and Louise D. McCullough, Ph.D. Authors’ statements appear in the manuscript.
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About the American Heart Association
The American Heart Association is a relentless force for the world to live longer, healthier lives. We are dedicated to ensuring good health in all communities. Through partnerships with many organizations and millions of volunteers, we fund innovative research, protect public health, and share life-saving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Join us at heart.org, Facebook, twitter or by calling 1-800-AHA-USA1.
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Maggie Francis: 214-706-1382; Maggie.Francis@heart.org
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