Top Things to Know: Effects of Objective and Perceived Social Isolation on CV and Brain Health
Prepared by Sally S. Wong, PhD, RD, CDN, FAHA – Senior Science and Medicine Advisor, Lead
- Social isolation is defined as the objective state of having few or infrequent social contact, whereas loneliness is defined as perceived isolation which is distressing for the individual.
- Social isolation and loneliness, though related, are distinct constructs which operate through different pathways to affect cardiovascular and brain health.
- Certain individuals and groups may be at higher risk of social isolation and loneliness and its impact on CVD based on aspects of their social identity (e.g., sexual or gender minorities), socioeconomic status, or place of residence (e.g., rural or under-resourced settings).
- Risk and protective factors for social isolation and loneliness have been well-described in the literature. These include predisposing physical health conditions (e.g., chronic illness, functional impairments); psychological and cognitive factors (e.g., depression, anxiety), socio-environmental factors (e.g., transportation, living arrangement, dissatisfaction with family relationships, pandemics, and natural disasters).
- Social isolation and loneliness have increased since the start of the COVID-19 pandemic, and the impact of social isolation and loneliness appears most pronounced among older adults, women, and low-income individuals.
- Data on the association of social isolation and/or loneliness with incident CHD, heart failure, dementia and cognitive impairment is sparse and mixed.
- Published reviews of interventions to alleviate loneliness and social isolation note the poor quality of the evidence due to the heterogeneous definitions and measurement of social isolation and loneliness, limited age ranges, small study samples, and limited follow-up.
- Despite the breadth of literature for cardiovascular outcomes, data on the association between social isolation and loneliness and various cardiovascular and brain health outcomes is mixed but suggests that social isolation and loneliness increase risk for and worsen outcomes in cardiovascular and brain health.
- Though recommended by the Institute of Medicine that data on social isolation and loneliness be included in electronic health records, this practice is still evolving and not widely adopted.
- There is a need to develop, implement, and evaluate hypothesis-driven interventions to reduce the adverse effects of social isolation and loneliness on cardiovascular and brain health.
Citation
Cené CW, Beckie TM, Sims M, Suglia SF, Aggarwal B, Moise N, Jiménez MC, Gaye B, McCullough LD; on behalf of the American Heart Association Social Determinants of Health Committee of the Council on Epidemiology and Prevention and Council on Quality of Care and Outcomes Research; Prevention Science Committee of the Council on Epidemiology and Prevention and Council on Cardiovascular and Stroke Nursing; Council on Arteriosclerosis, Thrombosis and Vascular Biology; and Stroke Council. Effects of objective and perceived social isolation on cardiovascular and brain health: a scientific statement from the American Heart Association. J Am Heart Assoc. 2022;11:e026493. doi: 10.1161/JAHA.122.026493