Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women

Hakulinen, Christian; Pulkki-Råbäck, Laura; Virtanen, Marianna; Jokela, Markus; Kivimäki, Mika; Elovainio, Marko

doi:10.1136/heartjnl-2017-312663

Cited by 238 publications

(236 citation statements)

References 28 publications

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“…These results support empirical evidence relating to both loneliness and to Social Cure theorising. In terms of the loneliness literature, the results are consistent with observations regarding the relationship between loneliness and depression (e.g., Hakulinen et al, 2018;Holt-Lunstad et al, 2015). Moreover, the finding that the serial mediation models became non-significant when depression was placed before loneliness supports work indicating that loneliness predicts depression regardless of initial depression levels (Cacioppo et al, 2010).…”

Section: Discussionsupporting

confidence: 87%

“…As with depression, there have been suggestions that many industrialized societies are facing a loneliness epidemic, with up to one-third of people affected (Cacioppo & Cacioppo, 2018a;King, 2018). The lonelinessdepression link is well-established (Hakulinen et al, 2018;Holt-Lunstad, Smith, Baker, Harris, & Stephenson, 2015), with research showing that loneliness predicts depression over time, regardless of initial depression levels (Cacioppo, Hawkley, & Thisted, 2010).…”

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confidence: 99%

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Longitudinal associations between family identification, loneliness, depression, and sleep quality

Wakefield

Bowe

Këllezi

et al. 2019

British J Health Psychol

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Objectives. The prevalence of depression and loneliness is increasing in Western nations, and both have been shown to cause poor sleep quality, with evidence suggesting that loneliness also predicts depression. The Social Cure perspective can shed light on these relationships and thus informs the present study. Specifically, it was hypothesized that the extent of participants' identification with a significant social group, their family, would positively predict sleep quality and that this relationship would be mediated by loneliness and depression. Design. A two-lave longitudinal online survey was used.Methods. Participants completed an online survey at T1 (N = 387) and 1 year later at T2 (N = 122) assessing the extent to which they identified with their family. Their loneliness, depressive symptomology, and sleep quality/insomnia severity were also measured.Results. Consistent with predictions, cross-sectional and longitudinal serial mediation models indicated that family identification was a negative predictor of loneliness, which in turn was a positive predictor of depression, which predicted poor sleep quality/insomnia.Conclusions. This is the first Social Cure study to explore the mediated relationship between social identification and sleep quality. As well as advancing the Social Cure perspective, these results have implications for how health professionals understand, prevent, and treat sleep problems. Statement of contributionWhat is already known on this subject?The prevalence of depression and loneliness is increasing in Western nations, and both have been shown to cause poor sleep quality. Weak social networks have been shown to predict restless sleep over time, and that depressed mood mediates this relationship.What does this study add? Family identification negatively predicted poor sleep quality cross-sectionally. Depression and loneliness positively predicted poor sleep quality over time.Depression and loneliness mediated the family identification-sleep quality relationship over time.

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

Longitudinal associations between family identification, loneliness, depression, and sleep quality

Wakefield

Bowe

Këllezi

et al. 2019

British J Health Psychol

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“…Factors that might confound any association between physical activity and loneliness were taken into account. For example, socioeconomic status was considered to be an important confounder for its association with physical activity levels and the fact that it partly explains links between social isolation/loneliness, disease risk and premature mortality . Health conditions (ie, chronic physical conditions, depression) were also adjusted for as poor health may limit the capacity for being physically active and induce loneliness .…”

Section: Introductionmentioning

confidence: 99%

Physical activity and loneliness among adults aged 50 years or older in six low‐ and middle‐income countries

Vancampfort

Lara

Smith

et al. 2019

Int J Geriat Psychiatry

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Introduction Loneliness is widespread and associated with deleterious outcomes in middle‐aged and older age people in low‐ and middle‐income countries (LMICs). Physical activity is one potential psychosocial strategy with the potential to reduce loneliness in this population. Thus, the aim of this study was to explore associations between physical activity (PA) and loneliness in middle‐aged and older people from six LMICs. Materials and methods Data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. Self‐reported data on loneliness and PA (as assessed by the Global Physical Activity Questionnaire) were collected. Participants were dichotomized into those who do and do not meet the international recommendation of 150 minutes of moderate to vigorous PA per week. Associations between loneliness and PA were examined using logistic regressions. Results Among 34 129 individuals aged 50 years or older, the prevalence of loneliness was higher among those not meeting the PA guidelines in all countries, although this difference was not significant in Mexico and South Africa. After full adjustment, not meeting PA guidelines was positively associated with loneliness in the meta‐analysis based on country‐wise estimates, with a moderate level of between‐country heterogeneity being observed (OR = 1.31; 95% CI, 1.07‐1.61; I2 = 48.7%). At an individual country level, statistical significance was only reached in Ghana (OR = 1.89; 95% CI = 1.44‐2.49). Discussion Our data suggest that physical inactivity and loneliness commonly co‐occur in adults aged 50 years or older in LMICs overall but that this association differs by country. Longitudinal studies are required to confirm these findings and investigate potential mechanisms that may inform future interventions.

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“…Despite considerable study into psychosocial consequences of TBI, there has been very little investigation into loneliness specifically. There is remarkable overlap between the effects of TBI and loneliness on health and well‐being; studies suggest that both loneliness and TBI are independently associated with increased depression, functional decline, medical comorbidities, mortality, and health‐care utilization . It is possible that the combination of TBI and loneliness may have harmful additive effects.…”

Section: Discussionmentioning

confidence: 99%

Lifetime history of traumatic brain injury is associated with increased loneliness in adults: A US nationally representative study

Kumar

Ornstein

Bollens‐Lund

et al. 2020

Int J Geriat Psychiatry

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Background/Objectives An estimated 55 million individuals worldwide live with chronic disability associated with traumatic brain injury (TBI), which may include cognitive, behavioral, and social impairments. Reduced participation in social activities is common after TBI; however, few studies have evaluated loneliness among survivors of TBI. The current study aimed to evaluate the association between history of TBI and loneliness and to identify mediators of this association. Methods/Design Retrospective cohort study. Nationally representative sample of N = 724 adults over age 50 years (Health and Retirement Study). Loneliness was evaluated using the 11‐item Revised University of California Los Angeles (R‐UCLA) Loneliness Scale (range 11‐33). Lifetime history of TBI evaluated retrospectively using the Ohio State University TBI Identification Method. We included the following covariates: age, sex, race, and education; and mediators: depressive symptoms, number of comorbidities, chronic pain, difficulty with activities of daily living, and social network index. Results History of TBI was associated with a 1.28‐point (95% CI, 0.46‐2.11; P < .05; Cohen's D = 0.284) increase in R‐UCLA Loneliness Scale scores after covariate adjustment. Individuals with more recent injuries (within 10 years) and multiple lifetime TBIs reported the highest loneliness scores. In the structural equation model, depressive symptoms partially mediated the relationship between TBI and loneliness. All models were adjusted for US population sampling weights. Conclusions History of TBI was associated with greater loneliness compared with individuals without TBI in a representative sample of US adults. Managing depressive symptoms and medical consequences of TBI may be a target to ameliorate reporting of loneliness in this population.

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Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women

Abstract: Isolated and lonely persons are at increased risk of AMI and stroke, and, among those with a history of AMI or stroke, increased risk of death. Most of this risk was explained by conventional risk factors.

Cited by 238 publications

References 28 publications

Longitudinal associations between family identification, loneliness, depression, and sleep quality

Longitudinal associations between family identification, loneliness, depression, and sleep quality

Physical activity and loneliness among adults aged 50 years or older in six low‐ and middle‐income countries

Lifetime history of traumatic brain injury is associated with increased loneliness in adults: A US nationally representative study

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