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 significance of the collected evidence. A review of what science knows about the effects of social isolation on health has revealed 90 papers conducted across half the world. Together they collect the data of 2.2 million people. The study also highlights that some diseases, such as cardiovascular disease and some cancers, are worse off when you live alone.
A group of scholars from various Chinese institutions have compiled all the research done since the 1980s that has looked specifically at the link between loneliness, or social isolation, and mortality. As is now almost customary in this field, they distinguish between the subjective, the feeling of being alone (loneliness), and the objective, the reduction in social relationships (metric of social isolation). 90% of the studies were conducted in industrialized countries, almost half of which were European countries. In all, more than 2.2 million people have been or are being persecuted for years (up to half a century). This makes it a large sample whose results have high statistical power.
This report, published Monday in Nature Human Behavior, shows that loneliness increases the risk of dying from any cause by an average of 14%. In almost all of the analyzed studies, other possible variables were controlled, such as gender, age, socioeconomic level, physical activity or previous illnesses such as smoking, alcoholism or diabetes. The situation is even worse when measuring the impact of social isolation, understood as a lack of social connections. The risk of death increases by 32%. According to the two dozen papers examining the effects by gender, men and women who say they feel lonely are at the same risk. However, the lack of social relationships aggravates the situation of men five percentage points more than that of women.
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The review authors also collected articles focused on different diseases, particularly cardiovascular disease and some cancers. In a total sample of more than 1 million people, social isolation increases the risk of dying from cardiovascular disease in the general population by 34%. Those who felt lonely were slightly, but not significantly, more likely to die from a heart problem. This result, along with that of all-cause mortality, suggests that the lack of social relationships is a better predictor of mortality risk than self-perceived feelings of loneliness.
The difference between loneliness and social isolation is confirmed in another part of the work, examining how they can worsen the development of cancer. While the risk of dying from this cause increased by 34% in the general population for those with few social connections, this percentage dropped to 9% for those who felt lonely.
“People who feel lonely but are not socially isolated have psychological distress but are able to cope with it because of their social networks”
Maoqing Wang, a researcher at Harbin Medina University in China, and four of the researchers
Although being alone and loneliness can be two sides of the same coin, according to Maoqing Wang, a researcher at 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 have an impact on mental health (eg, depression), and isolation has been shown to have an impact on cognitive and physical health.” Although there are studies , who looked at the medal as a whole, “according to our meta-analysis, the combined effect of social isolation and loneliness is no greater than the individual effects, and isolation alone affects premature mortality more.” For the Chinese scientist, “people who feel lonely have but are not socially isolated, experience psychological stress that they can withstand because of their social networks.” And this should be taken into account when designing public health policies and programs.
For Marco Inzitari, director of integrated care and research at the Pere Virgili Health Park in Barcelona, the power and the amount of data this work is collecting gives solidity to something that we have been watching for a long time. A life in solitude increases the risk of death.” Referring to the factors that might explain the impact of loneliness on mortality, Inzitari, the authors say, recalls that those who live alone take less care of themselves or find it more difficult to pursue a healthy lifestyle. “There are also a number of physiological effects that can affect the metabolism, the immune system or the circulatory system,” says the also professor at the UOC, the Open University of Catalonia. Previous work has shown how being alone, or feeling alone, increases cortisol levels. This hormone causes a series of cascading effects throughout the body.
A third factor that would explain the link between loneliness and mortality is mental. The authors of the review mention that the frequency of mental health problems such as depression is higher in people living alone. dr Teresa Moreno, member of the Spanish Society of Neurology, recalls that “depression increases the symptoms of neurodegenerative diseases such as Alzheimer’s and Parkinson’s”. And with that comes a move away from healthy lifestyle habits, which has a negative impact: “Older people who live alone develop these diseases earlier,” concludes Moreno.
“As you get older you suffer losses, your love, your friends, you are left alone. There is also fragility
Esther Roquer, President of the Catalan Society of Geriatrics and Gerontology
Geriatrician Esther Roquer, President of the Catalan Society of Geriatrics and Gerontology, remembers how it all began: “The older you get, the more you lose, your love, your friends, you are left alone. There is also fragility, you don’t go out anymore and relationships are lost. Nowadays, families are getting smaller, which doesn’t counteract the loneliness. You can also be surrounded by people, like in dormitories, but they still feel like they are alone.”
Both Roquer and Inzitari agree on what should be done to ensure that a mortality risk factor so important that it is preventable is effectively avoided. “In addition to raising public awareness of age discrimination.” [discriminación 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 exploit the administrative and social fabric; Here it is important to connect the health part with the social part,” because Roquer calls it “performing the social prescribing, prescribing activities, prescribing medicines”. But they also agree that societal change is needed because, according to the UOC professor, “there is something that goes deeper and that once again after the pandemic, we forget the elderly.”
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