Longitudinal associations between loneliness, social isolation and cardiovascular events

This study aimed to examine the association between loneliness, social isolation and cardiovascular disease (CVD), looking at both self-reported CVD diagnosis and CVD-related hospital admissions.

Data were derived from the English Longitudinal Study of Ageing linked with administrative hospital records and mortality registry data. The analytical sample size was 5850 for the analysis of self-reported CVD and 4587 of CVD derived from hospital records, with a follow-up up to 9.6 years. Data were analysed using survival analysis, accounting for competing risks events.

The mean age was 64 years (SD 8.3). About 44%-45% were men. Within the follow-up, 17% participants reported having newly diagnosed CVD and 16% had a CVD-related hospital admission. We found that loneliness was associated with an increased risk of CVD events independent of potential confounders and risk factors. The hazard of people with the highest level of loneliness was about 30% higher for onset CVD diagnosis (HR: 1.05, 95% CI: 1.01 to 1.09) and 48% higher for CVD-related hospital admissions (HR: 1.08, 95% CI: 1.03 to 1.14), compared with the least lonely. There was little evidence that social isolation was independently associated with the risk of either CVD diagnosis or admission.

Our findings provided strong evidence for the relationship between loneliness and cardiovascular events. Loneliness should be considered as a psychosocial risk factor for CVD in both research and interventions for cardiovascular prevention.