Loneliness should be viewed as a legitimate health risk in people who have a serious illness, say researchers who found that lonely cardiac patients are at greater risk of dying within a year after leaving hospital.
While previous research has already found that loneliness and poor social support are associated with a heightened risk of developing, and dying from, coronary artery disease, it was not clear if other types of heart disease are also influenced loneliness or if living alone might be as influential as feeling lonely.
Danish researchers examined the one-year health outcomes of 25,241 patients admitted to a specialist heart centre with either ischaemic heart disease, abnormal heart rhythm, heart failure or valve disease, between 2013 and 2014.
When they were discharged, 13,443 (53%) completed validated questionnaires on their physical health, psychological wellbeing, quality of life (Short Form 12; HeartQoL) and their levels of anxiety and depression (HADS).
They were also asked about health, including smoking, drinking, and how often they took their prescribed medicines. National data were used to find out if they lived alone or with other people.
Participants who said they felt lonely were nearly three times as likely to be anxious and depressed and to report a significantly lower quality of life as those who said they did not feel lonely.
At one-year follow up, researchers found that irrespective of the diagnosis, loneliness was associated with significantly poorer physical health.
Lonely women were nearly three times as likely to have died from any cause after a year as women who did not feel lonely, while lonely men were more than twice as likely to have died from any cause.
Although living alone was not associated with feeling lonely, it was associated with a lower risk of anxiety/depression than in those who lived with other people. Living alone was associated with a 39% higher risk of poor cardiac health among men.
The researchers caution that this is an observational study so they are unable to establish cause, but they add that their findings support previous research that suggests loneliness is associated with changes in cardiovascular, neuroendocrine and immune function as well as unhealthy lifestyle.
They add: “There are indications that the burden of loneliness and social isolation is growing. Furthermore, increasing evidence points to their influence on poor health outcomes being equivalent to the risk associated with severe obesity. Public health initiatives should therefore aim at reducing loneliness.”
Christensen AV, Juel K, Ekholm O et al. Significantly increased risk of all-cause mortality among cardiac patients feeling lonely. Heart 5 November 2019; doi 10.1136/heartjnl-2019-315460
https://heart.bmj.com/lookup/doi/10.1136/heartjnl-2019-315460
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