Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults.

Abstract

Loneliness is a prevalent social problem with serious physiological and health implications. However, much of the research to date is based on cross-sectional data, including our own earlier finding that loneliness was associated with elevated blood pressure. In this study, we tested the hypothesis that the effect of loneliness accumulates to produce greater increases in SBP over a fouryear period than are observed in less lonely individuals. A population-based sample of 229 50-68 year-old White, Black, and Hispanic men and women in the Chicago Health, Aging, and Social Relations Study was tested annually for each of five consecutive years. Cross-lagged panel analyses revealed that loneliness at study onset predicted increases in SBP 2, 3, and 4 years later (B = 0.152, SE = 0.091, p < .05, one-tailed). These increases were cumulative such that higher initial levels of loneliness were associated with greater increases in SBP over a 4-year period. The effect of loneliness on SBP was independent of age, gender, race/ethnicity, cardiovascular risk factors, medications, health conditions, and the effects of depressive symptoms, social support, perceived stress, and hostility. Keywordsloneliness; blood pressure; aging; social isolation Loneliness is a prevalent and serious social and public health problem (Cacioppo & Patrick, 2008). At any given time, up to thirty-two percent of adults over the age of 55 report feeling lonely (De Jong Gierveld & Van Tilburg, 1999), and from five to seven percent report feeling intense or persistent loneliness (Steffick, 2000;Victor, Scambler, Bowling, & Bond, 2005). Socially isolated individuals tend to feel lonely, but loneliness is not synonymous with being socially isolated. Loneliness is more accurately defined as the distressing feeling that accompanies discrepancies between one's desired and actual social relationships. Number of Direct correspondence to the first author at the Department of Psychology, University of Chicago, 940 E. 57 th St., Chicago, IL 60637, by fax to 773-702-6898, by telephone to 773-834-9152, or by hawkley@uchicago.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/journals/pag NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript relationships can be important, but perceived shortcomings in the quality of one's relationships are particularly closely linked to loneliness (Hawkley et al., 2008;Peplau & Perlman, 1982;Pinquart & Sőrensen, 2003). Prospective studies have shown that feelings of loneliness predict depressive sym...

Loneliness and Social Isolation: Risk Factors Long Overdue for Surveillance

“…• Diminished physical activity 13 • Diminished motor function 14,15 • Symptoms of depression 16 • Disrupted sleep and daytime dysfunction 17 • Impaired mental and cognitive function 18 • Increased systolic blood pressure 19 • Increased sympathetic tone and vascular resistance 20,21 • Increased hypothalamic pituitary adrenocortical activity 22,23 • Altered gene expression related to anti-inflammatory responses 24 • Altered immunity 25,26 Of greater concern, however, is an accumulating volume of research that highlights loneliness as a risk factor for both functional decline as well as increased mortality. 4,8,[27][28][29] In short, there is evidence that the subjective experience of loneliness can significantly contribute to premature death independently of other physical, behavioral, or psychological factors.…”

Genome-Wide Association Study of Loneliness Demonstrates a Role for Common Variation

“…Studies designed to identify the mechanisms underlying the association between loneliness and mortality have found that loneliness is associated with increased hypothalamic-pituitary-adrenocortical (HPA) activity (Adam et al, 2006;Cacioppo et al, 2006;Doane and Adam, 2010;Glaser et al, 1985;Kiecolt-Glaser et al, 1984;Steptoe et al, 2004), altered gene expression indicative of decreased inflammatory control and increased glucocorticoid insensitivity (Cole et al, 2007(Cole et al, , 2011, increased inflammation, elevated vascular resistance, and blood pressure (Hackett et al, 2012;Hawkley et al, 2006Hawkley et al, , 2010bJaremka et al, 2013), higher rates of metabolic syndrome (Whisman, 2010), diminished immunity (Dixon et al, 2006;Glaser et al, 2005;Kiecolt-Glaser et al, 1984;Pressman et al, 2005;StraitsTröster et al, 1994), increased risk for age-related cognitive decline and dementia (Wilson et al, 2007), and increased sleep fragmentation (Cacioppo et al, 2002;Hawkley et al, 2010a;Jacobs et al, 2006;Kurina et al, 2011). Cross-lagged panel analyses have also shown that loneliness has also been associated with changes in psychological states that can contribute to morbidity and mortality, including increased depressive symptomatology (Booth, 2000;Cacioppo et al, 2006Cacioppo et al, , 2010VanderWeele et al, 2011), lower subjective wellbeing (Kong and You, 2013;VanderWeele et al, 2012), heightened vigilance for social threats (Cacioppo et al, 2015b), and decreased executive functioning (Baumeister and DeWall, 2005;Cacioppo et al, 2000;…”

Coping with loneliness: Caregivers of cancer patients

“…Social support can buffer the negative impact of stressful life events on psychological distress, depression, and anxiety as well as alleviate one's loneliness (e.g. [10,14] ). Perceived social support is a "relationship transaction" characterized by the subjective receipt of psychological resources intended to bolster one's ability to cope with stress [9,43] .…”