Cardiovascular Implications of Loneliness and Social Isolation: Evidence From a Systematic Review
Author(s)
Sibylle Puntscher, Dr.1, veronika papon, MSc1, Sophia Spagl, MPH1, Marjan Arvandi, Dr.phil.1, Beate Jahn, Assoc.-Prof. PD Dr.1, Kaisu H. Pitkälä, MD, PhD, professor emerita2, Laura Coll-Planas, Prof.3, Iva Holmerova, Prof.4, Alzbeta Bartova, MSc4, Blanka Novotna, MSc4, Cristina Casajuana-Kögel, MSc5, Matthew Jones, Prof.6, Jill S. Litt, Prof., PhD7, Uwe Siebert, Univ.-Prof., Dr., MPH, MSc8, Ursula Rochau, Assoc.-Prof. Dr.1.
1Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria, 2Department of General Practice and Primary Health Care, University of Helsinki, Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland, 3University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain, 4Charles University, Prague, Czech Republic, 5Public Health Agency of Catalonia, Barcelona, Spain, 6University of the West of England, Bristol, United Kingdom, 7Institute for Global Health (ISGlobal); CIBER Epidemiología y Salud Pública (CIBERESP); Universitat Pompeu Fabra (UPF),, Barcelona, Spain, 8Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria; Harvard Chan School of Public Health, Boston, MA, United States; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
1Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria, 2Department of General Practice and Primary Health Care, University of Helsinki, Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland, 3University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain, 4Charles University, Prague, Czech Republic, 5Public Health Agency of Catalonia, Barcelona, Spain, 6University of the West of England, Bristol, United Kingdom, 7Institute for Global Health (ISGlobal); CIBER Epidemiología y Salud Pública (CIBERESP); Universitat Pompeu Fabra (UPF),, Barcelona, Spain, 8Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria; Harvard Chan School of Public Health, Boston, MA, United States; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
OBJECTIVES: Loneliness and social isolation are recognized risk factors for both mental and physical health conditions, including cardiovascular diseases (CVD) as the leading cause of death worldwide. This systematic review examines the association of loneliness and social isolation with CVD as part of the EU-Horizon 2020 project RECETAS.
METHODS: A systematic literature search was conducted in PubMed, PsycINFO, and Web of Science for peer-reviewed primary research studies. Eligible studies employed a longitudinal design on loneliness/social isolation and CVD and were published in English or German after 2003. Two reviewers independently screened articles, extracted data, and assessed study quality using the Newcastle-Ottawa Scale (NOS). Findings were summarized in a systematic evidence table.
RESULTS: From 3,197 records identified, 21 studies met the inclusion criteria. These studies were all published after 2008 and were conducted in the United Kingdom (n=8), United States (n=6), Australia (n=2), China (n=2), Japan (n=1), Denmark (n=1), and a multinational setting (n=1). Sample sizes ranged from 2,616 to 938,588 participants. Three studies examined loneliness, nine focused on social isolation, and nine assessed both. Measurement tools included mainly the UCLA Three-Item Loneliness Scale, Berkman-Syme Social Network Index, and the Lubben Social Network Scale. The most frequently reported outcomes were stroke (n=15) and myocardial infarction (n=12). Using Cox-proportional hazards models, logistic regressions, or discrete-time survival analyses, 15 studies reported statistically significant associations between loneliness and/or social isolation and CVD, five studies found no significant effect, and one study reported a significant protective effect of social isolation. Based on the NOS, all but one study were rated as high quality.
CONCLUSIONS: Evidence indicates that both loneliness and social isolation are associated with an increased risk of developing CVD. Given the significant healthcare burden posed by CVD, greater attention should be directed towards interventions that target the reduction of social isolation and loneliness.
METHODS: A systematic literature search was conducted in PubMed, PsycINFO, and Web of Science for peer-reviewed primary research studies. Eligible studies employed a longitudinal design on loneliness/social isolation and CVD and were published in English or German after 2003. Two reviewers independently screened articles, extracted data, and assessed study quality using the Newcastle-Ottawa Scale (NOS). Findings were summarized in a systematic evidence table.
RESULTS: From 3,197 records identified, 21 studies met the inclusion criteria. These studies were all published after 2008 and were conducted in the United Kingdom (n=8), United States (n=6), Australia (n=2), China (n=2), Japan (n=1), Denmark (n=1), and a multinational setting (n=1). Sample sizes ranged from 2,616 to 938,588 participants. Three studies examined loneliness, nine focused on social isolation, and nine assessed both. Measurement tools included mainly the UCLA Three-Item Loneliness Scale, Berkman-Syme Social Network Index, and the Lubben Social Network Scale. The most frequently reported outcomes were stroke (n=15) and myocardial infarction (n=12). Using Cox-proportional hazards models, logistic regressions, or discrete-time survival analyses, 15 studies reported statistically significant associations between loneliness and/or social isolation and CVD, five studies found no significant effect, and one study reported a significant protective effect of social isolation. Based on the NOS, all but one study were rated as high quality.
CONCLUSIONS: Evidence indicates that both loneliness and social isolation are associated with an increased risk of developing CVD. Given the significant healthcare burden posed by CVD, greater attention should be directed towards interventions that target the reduction of social isolation and loneliness.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH37
Topic
Epidemiology & Public Health, Study Approaches
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Mental Health (including addition)