Bin Yu1, Andrew Steptoe, Li-Jung Chen, Yi-Huei Chen, Ching-Heng Lin, Po-Wen Ku. 1. From the Institute of Psychology (Yu) and Nutritional Epidemiology Institute and School of Public Health (Yu), Tianjin Medical University, Tianjin, China; Department of Behavioural Science and Health (Steptoe), University College London, London, United Kingdom; Department of Exercise Health Science (Chen), National Taiwan University of Sport, Taichung; Department of Medical Research (Chen, Lin), Taichung Veterans General Hospital, Taichung; Institute of Public Health and Community Medicine Research Center (Lin), National Yang-Ming University, Taipei; Graduate Institute of Sports and Health (Ku), National Changhua University of Education, Changhua City; and Department of Kinesiology (Ku), National Tsing Hua University, Hsinchu City, Taiwan.
Abstract
OBJECTIVE: Social isolation and loneliness have been associated with increased incidence of cardiovascular disease (CVD), but few studies have evaluated the impact of social isolation and loneliness on mortality in people with existing CVD, and these are limited to Western populations. We examined whether social isolation and loneliness are associated with increased risk of mortality in individuals with established CVD in Taiwan. METHODS: The cohort was composed of 1267 patients with confirmed CVD 65 years or older followed up for up to 10 years. Cox proportional hazard regression models were used to examine the association between social isolation and loneliness at baseline and mortality at follow-up by adjusting for demographic variables, health-related behaviors, and health status. RESULTS: There were 593 deaths during the follow-up period. Social isolation was associated with increased risk of mortality after accounting for established risk factors (hazard ratio [HR] = 1.16; 95% confidence interval [CI] = 1.06-1.26), whereas loneliness was not associated with increased risk of mortality (HR = 0.95; 95% CI = 0.82-1.09). When both social isolation and loneliness were included in the model, social isolation maintained an association with mortality (HR = 1.16; 95% CI =1.07-1.27). CONCLUSIONS: Social isolation is associated with an increased risk of mortality in patients with CVD, and the effects are independent of loneliness. These findings expand our knowledge about the impact of social isolation on the outcomes of CVD in non-Western countries. Efforts to reduce isolation may have substantial benefits in terms of mortality in patients with CVD.
OBJECTIVE: Social isolation and loneliness have been associated with increased incidence of cardiovascular disease (CVD), but few studies have evaluated the impact of social isolation and loneliness on mortality in people with existing CVD, and these are limited to Western populations. We examined whether social isolation and loneliness are associated with increased risk of mortality in individuals with established CVD in Taiwan. METHODS: The cohort was composed of 1267 patients with confirmed CVD 65 years or older followed up for up to 10 years. Cox proportional hazard regression models were used to examine the association between social isolation and loneliness at baseline and mortality at follow-up by adjusting for demographic variables, health-related behaviors, and health status. RESULTS: There were 593 deaths during the follow-up period. Social isolation was associated with increased risk of mortality after accounting for established risk factors (hazard ratio [HR] = 1.16; 95% confidence interval [CI] = 1.06-1.26), whereas loneliness was not associated with increased risk of mortality (HR = 0.95; 95% CI = 0.82-1.09). When both social isolation and loneliness were included in the model, social isolation maintained an association with mortality (HR = 1.16; 95% CI =1.07-1.27). CONCLUSIONS: Social isolation is associated with an increased risk of mortality in patients with CVD, and the effects are independent of loneliness. These findings expand our knowledge about the impact of social isolation on the outcomes of CVD in non-Western countries. Efforts to reduce isolation may have substantial benefits in terms of mortality in patients with CVD.
Authors: Jared W Magnani; Danielle Ferry; Gretchen Swabe; Deborah Martin; Xirun Chen; Maria M Brooks; Everlyne Kimani; Michael K Paasche-Orlow; Stefán Ólafsson; Timothy Bickmore; Samar R El Khoudary Journal: Am Heart J Date: 2022-06-09 Impact factor: 5.099
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