Social isolation, loneliness, and all-cause mortality in patients with cardiovascular disease: a 10-year follow-up study
Open accessAbstract
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.
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A Chinese study of 1,267 older adults with cardiovascular disease found isolation predicted higher ten-year mortality after adjusting for other risk factors, whereas loneliness did not.
“An investigation of 1,267 older people with cardiovascular disease in China reported that social isolation was linked to increased mortality risk over ten years after taking other risk factors into account, while loneliness was not [27].”
From Social isolation: an underappreciated determinant of physical health (2022) · cites this paper as [27]
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- Authors
- Yu, B., Steptoe, A., Chen, L.-J., Chen, Y.-H., Lin, C.-H., & Ku, P.-W.
- Affiliations
- National Tsing Hua University (TW)
- Corresponding author
- Lin, Ching-Heng
- Ku, Po-Wen
- Venue
- Psychosomatic Medicine
- Published
- 2019-12-17
- Volume
- 82
- Issue
- 2
- Pages
- 208-214
- ISSN
- 0033-3174 (ISSN-L)
- 1534-7796
- OpenAlex
- W2995258668
- Cited by
- 108
- References
- 47
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 20 · 2023: 24 · 2022: 20 · 2021: 9 · 2020: 9
- FWCI
- 9.23
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Social Science Fund of China
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- social isolation, loneliness, all-cause mortality, cardiovascular disease, older adults, social determinants of health, non-Western populations, Taiwan
- MeSH terms
- Aged, Aged, 80 and over, Cardiovascular Diseases, Cause of Death, Female, Follow-Up Studies, Humans, Loneliness, Male, Social Isolation, Taiwan
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