Older Women Who Are Lonely May Be At Increased Risk For Cardiovascular Disease

Postmenopausal women experiencing social isolation and loneliness may be at increased risk for cardiovascular disease (CVD), according to results of a prospective cohort study published in JAMA Network Open.

Between March 2011 and March 2019, women aged 65 to 99 years who were included in the original Women’s Health Initiative study and had no history of CVD were recruited for this analysis. The participants (N=57,825) responded to surveys about social isolation and loneliness in 2011 to 2012 and 2014 to 2015 and were assessed for new CVD events through March 2019.

The study cohort included women aged mean 79.0 years (standard deviation [SD], 6.1), 89.1% who were White, 51.3% who had no college or vocational training, and 60.6% who had self-reported excellent or very good health.

Individuals who reported high scores for social isolation or loneliness were older (mean, 81.4 vs 79.0 years), more likely to self-report poorer health (17.4% vs 6.1%), and had lower RAND 36-Item Short Form Survey 10-item physical functioning scores (mean, 57.9 vs 72.0 points).

Social isolation and loneliness were correlated (r, 0.21; P <.001).

A total of 1599 CVD events occurred during follow-up. CVD events were more common among women who reported above-median social isolation (11.9 vs 6.1 per 1000 person-years [py]) and above-median loneliness (11.5 vs 7.4 per 1000 py).

After adjusting for covariates, incident major CVD was associated with social isolation (adjusted hazard ratio [aHR], 1.08; 95% CI, 1.03-1.12), loneliness (aHR, 1.05; 95% CI, 1.01-1.09), and both social isolation and loneliness (aHR, 1.13; 95% CI, 1.06-1.20).

Social support was inversely correlated with social isolation (r, -0.31; P <.001) and loneliness (r, -0.39; P <.001) but did not have a modifier effect on CVD risk (both P ³.48).

This study may have been limited by the bias among women who were excluded due to missing data, in which the excluded group tended to be older, have poorer self-reported health, lower physical function scores, and higher social isolation.

“The findings suggest that further research is needed to evaluate the effectiveness of various interventions to reduce social isolation and loneliness and their potential effects on CVD risk as well as overall quality of life,” the investigators noted. “…particularly acknowledging the widespread consequences of the COVID-19 pandemic for these psychosocial conditions, the study’s findings support the potential value of measuring social isolation and loneliness in primary care and referring older women to mental health or community resources to improve social connectedness and reduce feelings of loneliness.”

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Golaszewski NM, LaCroix AZ, Godino JG, et al. Evaluation of social isolation, loneliness, and cardiovascular disease among older women in the US. JAMA Netw Open. Published online February 2, 2022. doi:10.1001/jamanetworkopen.2021.46461