Study ties social isolation to premature death
People who are socially isolated are more likely to die prematurely,
regardless of underlying health problems, according to a study of the
elderly British population.
The findings, published online in the Proceedings of the National
Academy of Sciences, showed that when mental and physical health
conditions were factored out, the lack of social contact still led to
early death among 6,500 men and women tracked over seven years.
"They're dying of the usual causes, but isolation has a strong
influence," said an author of the study, Andrew Steptoe, an
epidemiologist at University College London.
The study also appeared to diminish the role that subjective feelings
of "loneliness," as opposed to the lack of social contact, may have on a
person's lifespan. Both lead to higher mortality risks, the study noted,
but the effect of feeling lonely diminishes once demographic and health
factors are taken into account.
Regardless of the distinction, the study reinforces the need to
increase social support for the elderly, even as it adds to debate over
the intertwined effects of social contact and feelings of loneliness in
old age. A similar look at retired Americans in 2012 reinforced multiple
studies that link loneliness to numerous illnesses, including heart
trouble and high blood pressure.
People living alone account for more than a quarter of US households,
and the proportion of Americans who said they had no one to talk to
about important matters grew from 10 percent in 1985 to 25 percent in
2004, according to authors of the British study. A 2010 European survey
showed that more than a quarter of Europeans age 50 and older reported
that they met friends, colleagues or family less than once a month.
Separating the effects of loneliness from those of isolation,
however, has not been easy for those who study rates of illness and
death. While isolation can be measured directly - by how many friends
you have or how often you have contact with family - loneliness is more
subjective, measured through survey questions about whether social needs
and expectations are being met.
A 1992 study of 2,000 heart patients suggested that having a
confidante was more important than social links alone. It showed that
relative mortality nearly tripled among those who had neither a partner
nor a confidante compared with those who had confidantes (whether they
were married or unmarried), according to the author of that study,
Redford Williams, director of the behavioural medical research centre at
"There is something about not having social support - that is not
acting through loneliness, nor through other health problems - that is
contributing to mortality," Williams said.
Confusing the picture are studies that show loneliness leading to
poor health, including higher blood pressure, heightened reaction to
stress and altered immune responses, all of which can lead to higher
"Unfortunately in our study, we can't tell which comes first,"
Steptoe said. "We did know that lonely people did have more illnesses."
Last year's report on loneliness, based on the US Health and
Retirement Study, showed that loneliness appeared to increase mortality
risk over six years, an association that could not be attributed to
social relationships or health behaviours, such as smoking and drinking.
Isolation may encourage poor lifestyle choices such as smoking,
inactivity and unhealthy diets, which factor into mortality rates, said
John Cacioppo, director of the Center for Cognitive and Social
Neuroscience at the University of Chicago, an author of the 2012 study.
He suggested that the British tradition of a "stiff upper lip" may mean
Britons who live alone "are less likely to admit to feeling lonely than
are residents of the US."
Nonetheless, Cacioppo said, "Whether or not loneliness predicts
mortality in the UK, it most certainly does predict lower well-being,
increased depressive symptomatology, and decreased cognitive functioning
in older adults in the UK as well as in the US. This makes it important
to address in the UK whether or not it predicts mortality."
Richard Suzman, director of the National Institute on Aging's
division of behavioural and social research, said: "It may be that
loneliness and ill health are much more entangled. The question is, does
loneliness lead to ill health or is it that when you get ill you get
more lonely - you don't get out, or people don't visit as much."
Loneliness and isolation "should get lots of attention because they
may be as important, as joint factors, as smoking," Suzman said.
Studies that involve interventions would help separate the different
effects of loneliness and isolation, he added. "Isolation wins out this
time, but I'd want an experiment to verify that."
The National Institute on Aging, part of the National Institutes of
Health, funded both the British study and last year's report on US
- Los Angeles Times