According to a decade-long study, loneliness was a bigger risk factor for diabetics developing cardiovascular disease than smoking, diet, and physical activity. The researchers say the findings should inform patient evaluations going forward.
While we know that lifestyle factors such as the amount we exercise, the food we eat, and the substances we consume can directly impact our health, another less tangible factor is starting to emerge in terms of how we thrive, or fail to: loneliness. Feeling lonely has previously been linked to premature death and, according to the CDC, a 2020 study showed that social isolation was linked to a roughly 50% higher risk of dementia, while poor social relationships were shown to increase heart disease risk by 29% and stroke by 32%.
Adding to the body of evidence showing that loneliness can be bad for our cardiovascular system is a new study on diabetics from the European Society of Cardiology. Researchers there examined the records of over 18,500 diabetics aged 37-73 years who are in the UK Biobank, a database of health and genetic data taken from over 500,000 participants. Based on the answers to questionnaires, the patients were given loneliness scores of 0-2.
Ten years later, 3,247 patients had developed cardiovascular disease (CVD). After adjusting for risk factors such as body mass index, cholesterol levels, sex, and age, the study found that those with the highest loneliness scores were 26% more likely than those with the lowest scores to fall prey to the illness. Of the metrics analyzed, the researchers say that loneliness was not as significant a factor as cholesterol, BMI and kidney function in developing CVD but that it did rank above diet, smoking, depression and physical activity as an influencing factor.
“Loneliness and social isolation are common in today's societies and have become a research focus during the last years, especially driven by the COVID-19 pandemic and the continuous digitalization of society,” wrote the researchers in an editorial accompanying the research. “The human species is inherently social by nature. Humans not only require the presence of others, but rely on meaningful social relationships to develop into healthy adulthood. These social interactions with family, friends, neighbors or colleagues are paramount for our physical and mental well-being.”
Quality versus quantity
In determining which patients got the highest loneliness scores, the researchers homed in on questions relating to whether or not people had someone in their lives to whom they could confide, as well as those simply asking if they felt lonely. Interestingly, the study also evaluated social isolation by looking at responses that indicated patients lived alone, didn't participate in social activities at least once a week, and had friends and family visit less than once a month.
The study found that social isolation itself wasn't a significant factor in determining cardiovascular disease risk, leading the researchers to conclude that it's the quality of social connections that mattered more than the quantity.
“The quality of social contact appears to be more important for heart health in people with diabetes than the number of engagements,” said study author Lu Qi of Tulane University School of Public Health and Tropical Medicine. “We should not downplay the importance of loneliness on physical and emotional health. I would encourage patients with diabetes who feel lonely to join a group or class and try to make friends with people who have shared interests.”
Qi added that asking diabetic patients about loneliness should be part of their overall health assessments going forward, and that those who indicate the condition should be referred to mental health services.
The findings were published in the European Heart Journal.
Source: European Society of Cardiology