Loneliness, social isolation, cardiovascular disease and mortality: a synthesis of the literature and conceptual framework

Sam Hodgson · Isabella V C Watts · Simon DS Fraser · Paul Roderick · Hajira Dambha‐Miller

189 citations0/0 files storedJournal of the Royal Society of Medicine

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Health disparities and outcomes Cardiac Health and Mental Health Death Anxiety and Social Exclusion

Abstract

To conduct a systematic review and develop a conceptual framework on the mechanisms linking loneliness, social isolation, health outcomes and mortality. Electronic databases were systematically searched (PubMed, MEDLINE, Scopus and EMBASE) from inception to October 2018 followed by manual searching to identify research on loneliness, social isolation and mortality in adults published in the English language. Articles were assessed for quality and synthesised into a conceptual framework using meta-ethnographical approaches. A total of 122 articles were included. These collated observational designs examining mediators and moderations of the association in addition to qualitative studies exploring potential mechanisms were included. A framework incorporating 18 discrete factors implicated in the association between loneliness, social isolation and mortality was developed. Factors were categorised into societal or individual, and sub-categorised into biological, behavioural and psychological. These findings emphasise the complex multidirectional relationship between loneliness, social isolation and mortality. Our conceptual framework may allow development of more holistic interventions, targeting many of the interdependent factors that contribute to poor outcomes for lonely and socially isolated people.

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References

2009The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration 2009The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration 2015Loneliness and Social Isolation as Risk Factors for Mortality 1980The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence.2010Loneliness Matters: A Theoretical and Empirical Review of Consequences and Mechanisms 2013Social isolation, loneliness, and all-cause mortality in older men and women 2006Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups 2016Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies

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