Loneliness and solitude have long been studied for their detrimental health effects, and researchers have once again found that those who report feeling lonely or living alone have a higher risk of dying than those who don’t, according to two studies published Monday in the Archives of Internal Medicine. Both studies, however, highlight the complexities of determining why a lack of close friends or roommates would hasten our demise.
“These studies reaffirm that this association between poor social support and adverse health outcomes does exist but they don’t delve deeper into identifying the mechanisms that might explain the connection,” said Emily Bucholz, a student at Yale University School of Medicine who co-wrote an editorial that accompanied the studies.
In one, researchers at Brigham and Women’s Hospital examined survey data from nearly 45,000 volunteers from the United States and other countries and found that among middle-aged adults, nearly 8 percent of those who reported living alone at the beginning of the study had died four years later compared with nearly 6 percent of those who lived with someone when the study began. What’s odd is that the researchers didn’t find a correlation between living alone and death among people over age 80.
“We approached the living alone status as proxy of social support,” said author Dr. Jacob Udell, a cardiologist at the Brigham, “and the presumption is that those in their 40s and 50s who are living alone have less social support than older people.”
They may have, for example, recently gone through an emotionally-draining divorce, which can sometimes leave a person feeling more isolated than, say, after a spouse’s death, which tends to occur later in life. Or perhaps these middle-aged folks never lived with a partner nor had children, whereas an 80-year-old living alone might have kids to help care for them.
“This is the first study we’re aware of that has demonstrated this difference,” said Udell, “so we need further studies to confirm the difference and to determine the reason for it.”
Perhaps the association could be due to a delay in seeking medical care to evaluate chest pain or some other life-threatening symptom among those who have no one at home, Udell theorized, or perhaps living alone caused more depression, which is known to exacerbate heart disease and other health conditions.
The researchers found a significantly higher risk of death only among middle-aged adults who already had established heart disease, and they couldn’t ascertain what role, if any, mood or other mental health factors may have played.
That was addressed in a different study published in the same journal, which linked loneliness to less mobility and an earlier death in those over age 60. Researchers from the University of California, San Francisco asked more than 1,600 volunteers whether they felt isolated, left out, or lacking in companionship, and they found that more than 40 percent reported feeling lonely, which increased their risk of experiencing physical decline and of dying over the course of the six-year study. (The researchers were able to account for depression and other chronic diseases.)
In contrast to the living-alone study, however, the loneliness study found that “a large number of participants who reported feeling lonely were married or did not live alone,” the researchers wrote.
Perhaps, it’s our perception of being a rock or an island, as Simon and Garfunkel sang, that leads to our downfall. But I’m not convinced either of these new studies can provide us with that answer, which is a shame. Both sets of researchers contend their studies point to the need for improved social support, which is probably the case. Unfortunately, experts still don’t have a clue what sort of support is really needed to improve our health and extend our lifespans.
Would stroke or heart attack patients benefit from a cardiovascular rehabilitation program that includes group therapy? Should doctors screen for loneliness in patients who are married?
“Loneliness in itself is a good thing to target but how to fix that is challenging,” said Bucholz. For instance, pets have been known to alleviate feelings of solitude but they won’t urge their owners to seek medical treatment when symptoms arise. On the flip side, moving someone who lives alone into a long-term care facility may increase the odds of prompt medical care but may not take away that sense of isolation and hopelessness.