That loneliness kills is not new. Experts and scientific studies had already established the connection between being alone and shortening of life. What is new is the forcefulness of the accumulated evidence. A review of what science knows about the impact of social isolation on health has found 90 works carried out in half the world. Together, they collect the data of 2.2 million people. The study also highlights that some diseases, such as cardiovascular diseases and some types of cancer, progress worse when living alone.
A group of scientists from various Chinese institutions have compiled all the research conducted since the 1980s that has specifically studied the relationship between loneliness or social isolation and mortality. As is now almost the norm in this field, they differentiate between the subjective, the feeling of being alone (loneliness), and the objective, the reduction of social relationships (metric of social isolation). 90% of the studies were carried out in developed countries, almost half of which were European. In total, more than 2.2 million people were or are being followed for years (up to half a century). This makes it a large sample whose results have a high statistical power.
This review, published this Monday in Nature Human Behavior, shows that, on average, loneliness increases the risk of dying from any cause by 14%. In almost all the studies analyzed, other possible variables were controlled, such as gender, age, socioeconomic level, physical activity or previous conditions, such as smoking, alcoholism or diabetes. The situation is worse when what is measured is the impact of social isolation, understood as the scarcity of social relationships. So, the risk of mortality is compounded by 32%. According to the two dozen works that studied the impact according to gender, men and women who say they feel lonely have the same risk. However, the lack of social relations aggravates the situation of men more than that of women by five percentage points.
The review authors also collected papers focusing on different diseases, particularly cardiovascular and some types of cancer. With a combined sample of more than one million people, social isolation increases the risk of dying from a circulatory pathology among the general population by 34% higher among people. Meanwhile, those who feel lonely, although they had a slight increase in the probability of dying from a heart problem, it was not significant. This result, together with that of mortality from any cause, suggests that the lack of social relationships predicts the risk of mortality better than the feeling of loneliness, which is self-perceived.
The difference between loneliness and social isolation is confirmed in another part of the work, when they review how they can aggravate the evolution of cancer. While the risk of dying from this cause among the general population increased by 34% among those who had few social relationships, this percentage dropped to 9% in the case of those who felt lonely.
“People who feel lonely, but are not socially isolated, have mental health stress, but can cope with it because of their social networks”
Maoqing Wang, a researcher at Harbin Medina University in China, and four of the research
Although being alone and feeling lonely can be two sides of the same coin, for Maoqing Wang, a researcher at the Harbin Medical University (China) and co-author of the review, “isolation is worse than loneliness.” In an email, Wang adds: “Loneliness has been shown to predict mental health (eg, depression) and isolation has been shown to predict cognitive and physical health.” Although there are studies that have looked at the coin as a whole, “according to our meta-analysis, the combined effect of social isolation and loneliness is no greater than the separate effects, and isolation alone influences premature mortality more strongly.” For the Chinese scientist, “people who feel lonely but are not socially isolated have mental health stress, but they can resist it due to their social networks.” And this should be taken into account when designing public health policies and programs.
For the director of Integrated Care and Research at the Pere Virgili Health Park in Barcelona, Marco Inzitari, “the power, the amount of data that this work gathers, gives solidity to something that we have been observing for a long time, that living in solitude raises the risk of mortality”. Regarding the factors that could explain the impact of loneliness on mortality, Inzitari recalls, as the authors say, how those who live alone take less care of themselves or find it more difficult to follow a healthy lifestyle. “There are also a series of physiological effects that can affect metabolism, the immune system or circulation”, says the also professor at the UOC, the Open University of Catalonia. Previous work has shown how being or feeling alone elevates cortisol release. This hormone causes a series of cascading effects throughout the body.
A third factor that would explain the relationship between loneliness and mortality is in the head. The authors of the review mention in it that the incidence of mental problems such as depression is higher in people who live alone. Dr. Teresa Moreno, a member of the Spanish Society of Neurology, recalls that “depression advances the symptoms of neurodegenerative diseases, such as Alzheimer’s and Parkinson’s.” And this is accompanied by the abandonment of healthy lifestyle habits, feeding back: “Elderly people who live alone develop these diseases earlier,” Moreno concludes.
“As you get older you are having losses, your love, your friends, you are left alone. Fragility also comes
Esther Roquer, president of the Catalan Society of Geriatrics and Gerontology
The geriatrician Esther Roquer, president of the Catalan Society of Geriatrics and Gerontology, remembers how it all began: “As you get older you are having losses, your love, your friends, you are left alone. Fragility also arrives, you stop going out and relationships are lost. Now families are smaller, which does not help to combat loneliness. Also, you can be surrounded by people, like in residences, but they still have the feeling of being alone”.
Both Roquer and Inzitari agree on what should be done to ensure that a mortality risk factor so prominent that it is avoidable is effectively avoided. “In addition to raising awareness among the population against ageism [discriminacion social por la edad, el arrinconamiento de los viejos], it would be necessary to integrate the social and health services ”, says the geriatrician. For Inzitari, “we must take advantage of the administrative and social fabric; here it is important to integrate the health part with the social one”, for what Roquer calls “doing the social prescription, prescribing activities as medicines are prescribed”. But they also agree that a social change is necessary because, in the words of the UOC professor, “there is something that is deeper and after the pandemic, once again we are forgetting about the elderly.”
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Source: EL PAIS
