Loneliness, social isolation, cardiovascular disease and mortality: a synthesis of the literature and conceptual framework

Abstract

To conduct a systematic review and develop a conceptual framework on the mechanisms linking loneliness, social isolation, health outcomes and mortality. Electronic databases were systematically searched (PubMed, MEDLINE, Scopus and EMBASE) from inception to October 2018 followed by manual searching to identify research on loneliness, social isolation and mortality in adults published in the English language. Articles were assessed for quality and synthesised into a conceptual framework using meta-ethnographical approaches. A total of 122 articles were included. These collated observational designs examining mediators and moderations of the association in addition to qualitative studies exploring potential mechanisms were included. A framework incorporating 18 discrete factors implicated in the association between loneliness, social isolation and mortality was developed. Factors were categorised into societal or individual, and sub-categorised into biological, behavioural and psychological. These findings emphasise the complex multidirectional relationship between loneliness, social isolation and mortality. Our conceptual framework may allow development of more holistic interventions, targeting many of the interdependent factors that contribute to poor outcomes for lonely and socially isolated people.

Loneliness and Risk for Cardiovascular Disease: Mechanisms and Future Directions

“…To date, a number of psychological, biological, and behavioural pathways to health and mortality from loneliness have been identified [ 28 , 29 ]. Several researchers who have conceptualised the relationships amongst these variables begin with the observation that humans are social creatures, and that proximity to other humans is necessary for survival [ 30 , 31 ].…”

“…Perceived social isolation is therefore a source of threat and danger, which activates behavioural and psychological mechanisms via biological and molecular pathways [ 29 – 31 ]. These mechanisms in turn lead to increased risk for premature mortality and disease [ 28 , 32 ]. Identifying these pathways is crucial for developing appropriate interventions and prevention targets [ 28 •].…”

“…These mechanisms in turn lead to increased risk for premature mortality and disease [ 28 , 32 ]. Identifying these pathways is crucial for developing appropriate interventions and prevention targets [ 28 •]. Below, we review the recent evidence for these pathways whilst acknowledging that the mechanisms also likely interact with each other and operate bidirectionally.…”

Cuarentena y COVID-19, una percepción más allá de la infección

“…Tanto la soledad como el aislamiento social han sido asociados también con comportamientos menos saludables como el tabaquismo, la inactividad física y trastornos del sueño 18,19 , estos factores, se encuentran directamente asociados a procesos biológicos relevantes para la salud, como son las variaciones en la presión arterial, incremento en marcadores séri-LETTER TO EDITOR / CARTA AL EDITOR DOI. 10.21931/RB/2021.06.02.2 cos inflamatorios, alteraciones en el metabolismo de lípidos y compromiso inmunológico 15,20,21 e incluso niveles de asociación con riesgo de muerte prematura 22 .…”

The many uncertainties of COVID-19

“…3 What are some of the clinical effects of loneliness and social isolation? 4 Was lockdown even the right policy option? 5 Either way, what are the conditions now required to exit it?…”