Are social isolation, lack of social support or loneliness risk factors for cardiovascular disease in Australia and New Zealand? A systematic review and meta‐analysis

Abstract

Background: An international systematic review concluded that individuals with poor social health (social isolation, lack of social support or loneliness) are 30% more likely to develop coronary heart disease (CHD) and stroke. Notably, the two included Australian papers reported no association between social health and CHD or stroke.Objective: We undertook a systematic review and meta-analysis to investigate the association between social isolation, lack of social support and loneliness and cardiovascular disease (CVD) incidence among people living in Australia and New Zealand.Methods: Four electronic databases were systematically searched for longitudinal studies published until June 2020. Two reviewers undertook title/abstract screen and one reviewer undertook full-text screen and data extraction. Quality was assessed using the Newcastle -Ottawa Quality Assessment Scale. Results:Of the 725 unique records retrieved, five papers met our inclusion criteria.These papers reported data from three Australian longitudinal datasets, with a total of 2137 CHD and 590 stroke events recorded over follow-up periods ranging from 3 to 16 years. Reports of two CHD and two stroke outcomes were suitable for metaanalysis. The included papers reported no association between social health and incidence of CVD in all fully adjusted models and most unadjusted models. Conclusions:Our systematic review is inconclusive as it identified only a few studies, which relied heavily on self-reported CVD. Further studies using medical diagnosis of CVD, and assessing the potential influence of residential remoteness, are needed to better understand the relationship between social health and CVD incidence in Australia and New Zealand.

Social Isolation and Social Support Influence Health Service Utilisation and Survival after a Cardiovascular Disease Event: A Systematic Review

“…An alternative approach for future research could be to conduct a systematic review for each theme, incorporating more countries. Notably, prior apprehensions regarding the potential null association between social health and cardiovascular disease in Australia [ 13 ] have been overcome with a validated, medically diagnosed measure of CVD (rather than prior publications assessing self-report CVD) [ 6 ]. While each country has unique social and healthcare systems and population characteristics, there are no specific reasons why this review is not generalisable to other high-income countries.…”

“…People can feel that the support is unhelpful or creates social constraints [ 11 ]. Despite the ample literature describing these social health concepts, they have been historically assessed as substitutes in health research; however, research has emerged demonstrating that these concepts should be separated, with different implications for health and well-being [ 6 , 7 , 8 , 12 , 13 , 14 , 15 , 16 ]. Thus, it may be important to focus on one disease outcome.…”

Socioeconomic, Behavioural, and Social Health Correlates of Optimism and Pessimism in Older Men and Women: A Cross-Sectional Study

“…Social support is a subjective perception of the availability of resources from others, while loneliness is a subjective negative feeling of being isolated [ 55 ]. There is overwhelming evidence that poor social health is associated with a greater severity of chronic disease risk factors [ 56 ], lower quality of life [ 57 , 58 ], and mental ill health during cardiovascular disease recovery [ 59 ], as well as an increased risk of cardiovascular disease [ 60 , 61 , 62 ], dementia [ 62 , 63 ], and mortality [ 64 ]…”

“…We observed that older adults who do volunteer work or are less lonely are more likely to be more optimistic and less pessimistic, while low social support was associated with higher pessimism. Since social isolation, social support, and loneliness are considered independent predictors for depression, anxiety, cognitive decline, and even mortality in older adults [ 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ], our novel results offer unique insights using a cluster of measurements of social health with future expectancies in older men and women.…”

Ageing with Interstitial lung disease: preserving health and well being

“…smoking) and associated with higher rates of depression, anxiety, and suicide [137,138,139 ▪▪ ]. Pre-COVID-19 loneliness measured in several countries suggested epidemic proportions in the ageing and those with chronic health conditions [137,139 ▪▪ ,140,141,142 ▪▪ ]. Loneliness, depression and mortality are accelerated to significant proportions in family caregivers as well as in many people living with ILD [132 ▪ ,143 ▪▪ ,144 ▪▪ ,145–149,150 ▪▪ ,151–154].…”