The Heart Is a Lonely Hunter: Living Alone Linked With Mortality Risks

From Heartwire

The Heart Is a Lonely Hunter: Living Alone Linked With Mortality Risks

Michael O’Riordan

June 20, 2012 (New York, New York) — That husband or wife, boyfriend or girlfriend, or even the college-aged kid who suddenly moved back home might be getting on your last nerve, but new data suggest they could help you live a longer life [1]. In an analysis of more than 40 000 middle-aged subjects with atherothrombosis, living alone was associated with an increased risk of death and cardiovascular death in all but the oldest of patients.

Solo habitation, which is often used a stand-in for a lack of social support, was associated with a 24% increased risk of dying over a four-year follow-up period in individuals 45 to 65 years of age when compared with individuals who lived with others, report Dr Jacob Udell (Brigham and Women’s Hospital, Boston, MA) and colleagues in a study published online June 19, 2012 in the Archives of Internal Medicine. The increased risk was not observed in subjects older than 80 years of age.

Numerous studies published over the years have shown that social isolation, including the lack of real or perceived social support, might have an adverse effect on health, including cardiovascular health, although the results are mixed. Some studies have suggested that the extent to which individuals interact and are integrated with one another predicts MI and coronary heart disease, as well as smoking status, cholesterol levels, and blood pressure, according to the researchers.

Using data from the Reduction of Atherothrombosis for Continued Health (REACH) database, Udell and colleagues investigated whether living alone was associated with increased mortality and cardiovascular mortality in 44 573 subjects with or at risk of atherothrombosis. Of these, 8594 (19.3%) were living alone. During the follow-up period, there were 4338 deaths and 2612 deaths due to cardiovascular causes.

The four-year mortality rate among subjects living alone was 14.1% compared with 11.1% for those living with another person, while the four-year rate of cardiovascular death was 8.6% in those who lived solo compared with 6.8% in people who lived with others. This translated into a 27% increased risk of death and a 25% increased risk of cardiovascular death, both of which were statistically significant (p

Four-Year Hazard Ratios Associated With Living Alone

OutcomeHazard ratio (95% CI)
Mortality (overall, unadjusted)1.27 (1.19–1.37)
45 to 65 (age, y)1.24 (1.01–1.51)
66 to 80 1.12 (1.01–1.26)
>800.92 (0.79–1.06)
Cardiovascular death1.25 (1.14–1.37)
45 to 65 (age, y)1.29 (1.01–1.64)
66 to 80 1.11 (0.96–1.28)
>800.93 (0.77–1.12)

“Younger individuals who live alone may have a less favorable course than all but the most elderly individuals following development of cardiovascular disease, and this observation warrants confirmation in further studies,” write Udell and colleagues. “Younger patients living alone after an atherothrombotic ischemic event may be an additional risk group on which to focus efforts to improve prognosis.”

In addition to this study, researchers led by Dr Carla Perissinotto (University of California, San Francisco) showed that loneliness was a predictor of functional decline and mortality in individuals older than 60 years of age [2]. In 1604 adults participating in the Health and Retirement Study, loneliness, assessed via a psychosocial questionnaire, was associated with a 59% decline in activities of daily living, as well as significant declines in physical function. Lonely people also had a significant 45% increased risk of mortality compared with individuals who were not lonely.

“Loneliness is a common source of suffering in older persons,” write Perissinotto et al. “We demonstrated that it is also a risk factor for poor health outcomes, including death, and multiple measures of functional decline. It persisted after accounting for a large number of confounders, including illness severity and depression.”