Social isolation and loneliness are independently associated with an 11% to 16% higher risk for CVD among older women, according to research published in JAMA Network Open.

Natalie M. Golaszewski

“Social isolation and loneliness, while related to one another, are distinct social factors and our study showed that both factors are associated with increased risk for cardiovascular disease among older women,” Natalie M. Golaszewski, PhD, a postdoctoral fellow with the Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, told Healio. “The overall CVD risk was highest for women who had high social isolation and high loneliness.”

In a prospective study, Golaszewski and colleagues analyzed data from 57,825 older women participating in the Women’s Health Initiative II study with no history of CVD at baseline (mean age, 79 years; 89.1% white). Participants completed questionnaires assessing social isolation and loneliness. The main outcome was major CVD, defined as CHD, stroke and CV death.

During 186,762 person-years, researchers observed 1,599 major CVD events.

Compared with women reporting low social isolation scores, women with high social isolation scores were 18% more likely to experience a major CVD event (HR = 1.18; 95% CI, 1.13-1.23). Similarly, women with a high loneliness score were 14% more likely to experience a major CVD event vs. those with low loneliness scores (HR = 1.14; 95% CI, 1.1-1.18). The risk was slightly attenuated but persisted after adjusting for health behaviors and health status, with an HR of 1.08 for women with a high vs. low social isolation score (95% CI, 1.03-1.12) and an HR of 1.05 for women with a high vs. low loneliness score (95% CI, 1.01-1.09).

Women with both high social isolation and high loneliness scores had a 13% to 27% higher risk for incident CVD compared with women with low social isolation and low loneliness scores. Social support was not a significant effect modifier of the associations.

“Both social isolation and loneliness are social factors that are important in the lives of patients and should be incorporated in clinical conversations and systematically measured in doctors’ offices,” Golaszewski told Healio. “It is important to further understand the acute and long-term effects of social isolation and loneliness on cardiovascular health and overall well-being.”

John Bellettiere

Causal information is also needed to confirm conclusions from the study that reducing social isolation and loneliness can reduce CVD, according to John Bellettiere, PhD, assistant professor of epidemiology at the Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego.

“This could take the form of randomized clinical trials or causal evaluations of existing programs designed to reduce social isolation and loneliness such as programs in the U.K.,” Bellettiere told Healio.