Lonely older women at greater risk of heart disease, new research suggests

Many lonely older women develop heart conditions, suggesting a link between loneliness and the toll it takes on the heart, while lockdowns have further increased this very real risk, new research unearths.

The study found an increase in heart disease risk of up to 27% in postmenopausal women who experience both high levels of social isolation – which we've seen enforced on and off over the past couple of years due to social distancing and quarantining – and loneliness.

The findings – published online by JAMA Network Open – reveal that social isolation and loneliness independently increased cardiovascular disease risk by 8% and 5% respectively.

But, if older women experienced high levels of both isolation and loneliness, their risk rose 13% to 27%, compared to women who reported low levels of each.

Study first author Doctor Natalie Golaszewski said, "We are social beings.

"In this time of COVID-19, many people are experiencing social isolation and loneliness, which may spiral into chronic states," suggesting the afflictions can become ongoing.

Dr Golaszewski, of the Herbert Wertheim School of Public Health and Human Longevity Science at University of California, San Diego, added, "It is important to further understand the acute and long-term effects these experiences have on cardiovascular health and overall well-being."

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She explained that social isolation and loneliness are "mildly correlated" and can occur at the same time, but they are not mutually exclusive. For example, a socially isolated person does not always feel lonely and a person experiencing loneliness is not necessarily socially isolated.

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Study author Dr John Bellettiere, assistant professor of epidemiology at the Herbert Wertheim School of Public Health, added, "Social isolation is about physically being away from people, like not touching or seeing or talking to other people.

"Loneliness is a feeling, one that can be experienced even by people who are regularly in contact with others." I.e, people can feel lonely in a busy and crowded room, or with friends around them.

Dr Bellettiere branded social isolation and loneliness as a "growing public health concern" as they are associated with health conditions that increase the risk of cardiovascular disease, including obesity, smoking, physical inactivity, poor diet, high blood pressure and high cholesterol.

When the researchers included all of these health behaviours and conditions in their study, and adjusted for diabetes and depression, high social isolation and loneliness remained "strongly linked" with increased risk for heart disease.

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As social networks shrink, older adults are more at risk for social isolation and loneliness, the researchers said. A quarter of adults age 65 or older report social isolation, while one-in-three adults 45 or older report being lonely.

Dr Bellettiere said, "We do not yet know whether the increased risk of cardiovascular disease is due to acute exposure to social isolation and loneliness or whether prolonged exposure accumulated over a lifetime is the culprit.

"Further studies are needed to better understand that."

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The new study was of more than 57,000 postmenopausal American women who had previously responded to questionnaires assessing social isolation, from 2011 to 2012. They were then sent a second questionnaire assessing loneliness and social support in 2014 to 2015.

Participants were followed from the time of questionnaire completion through 2019, or when they were diagnosed with cardiovascular disease. A total of 1,599 of the participants experienced cardiovascular disease.

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Dr Golaszewski said, "Measures of social isolation and loneliness – even with brief questions as was done in our study – should be incorporated into standard care."

She added, "We monitor our patient's' blood pressure, weight and temperature, and it might also be beneficial to capture the social needs that individuals may be lacking to better understand cardiovascular risk and develop solutions."