Social isolation and loneliness may be associated with higher rates of heart failure (HF), but whether or not a person feels lonely is more important in determining risk than if they are actually alone, according to a study published Feb. 1 in JACC: Heart Failure.

Yannis Yan Liang, MD, PhD, et al., conducted a population-based cohort study to examine the association of social isolation, loneliness, and their combination with incident HF. Data from the UK Biobank study was used, which followed population health outcomes over 12 years and assessed psychosocial factors like social isolation and loneliness through self-reported questionnaires. Researchers looked at health outcomes for a population of more than 400,000 middle-aged and older adults.

Results showed that both social isolation and loneliness increased the risk of hospitalization or death from HF by 15% to 20%. Among the 464,773 participants, 12,898 incident HF cases were documented during a median follow-up of 12.3 years. However, they also found that social isolation was only a risk factor when loneliness was not also present. Loneliness also increased risk even if the person was not socially isolated. Loneliness and social isolation were more common in men and were also associated with adverse health behaviors and status, such as tobacco use and obesity.

The researchers note that these results suggest that “loneliness is likely a stronger psychological stressor than social isolation because loneliness is common in individuals who are hostile or have stressful social relationships” and that the findings are especially relevant as the COVID-19 pandemic has highlighted the impacts of social isolation and loneliness across a broad range of health outcomes.

In an accompanying editorial comment, Sarah J. Goodlin, MD, FACC, and Sheldon Gottlieb, MD, FACC, note social isolation and loneliness are often impacted by an individual’s socioeconomic status. They go on to say that “the relationship with social isolation and loneliness is probably strongest in persons at extremes of social isolation and loneliness and compounded by low socioeconomic status.” 

Clinical Topics: COVID-19 Hub, Geriatric Cardiology

Keywords: Middle Aged, Male, Aged, Pandemics, Tobacco, Follow-Up Studies, Biological Specimen Banks, Cohort Studies, COVID-19, Self Report, Hospitalization, Risk Factors, Socioeconomic Factors

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