Effects of Objective and Perceived Social Isolation on Cardiovascular and Brain Health: A Scientific Statement From the American Heart Association.
Effects of Objective and Perceived Social Isolation on Cardiovascular and Brain Health: A Scientific Statement From the American Heart Association.
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DOI：
10.1161/jaha.122.026493
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发表时间：
2022-08-16
影响因子：
5.4
通讯作者：
McCullough, Louise D.
中科院分区：
文献类型：
--
作者：
Cene, Crystal W.;Beckie, Theresa M.;Sims, Mario;Suglia, Shakira F.;Aggarwal, Brooke;Moise, Nathalie;Jimenez, Monik C.;Gaye, Bamba;McCullough, Louise D.
社会孤立、相对缺乏或很少接触不同类型的社会关系以及孤独感（感知的孤立）与不良健康结果相关。回顾观察性和干预性研究，检查社会孤立和孤独对心血管和大脑健康的影响，并讨论观察到的关联的拟议机制。我们对现有研究进行了系统的范围审查。我们检索了 4 个数据库：PubMed、PsycInfo、Cumulative Index of Nursing and Allied Health 和 Scopus。最一致的证据表明，社会孤立、孤独、冠心病和中风死亡率之间存在直接关联。然而，关于社会孤立和孤独与心力衰竭、痴呆和认知障碍之间关系的数据很少且不够可靠。很少有研究使用适当的解释性分析方法，对社会孤立、孤独、心血管和大脑健康结果之间的中介途径进行实证检验。值得注意的是，效果估计很小，并且可能存在无法测量的关联混杂因素。对可能面临更高风险或更容易受到社会孤立影响的群体的研究是有限的。我们没有发现任何旨在减少社会孤立或孤独对心血管或大脑健康结果的不利影响的干预研究。社会孤立和孤独很常见，似乎是心血管和大脑健康恶化的独立危险因素；然而，关联的一致性因结果而异。有必要制定、实施和测试干预措施，以改善社交孤立或孤独的人的心血管和大脑健康。
Social isolation, the relative absence of or infrequency of contact with different types of social relationships, and loneliness (perceived isolation) are associated with adverse health outcomes. To review observational and intervention research that examines the impact of social isolation and loneliness on cardiovascular and brain health and discuss proposed mechanisms for observed associations. We conducted a systematic scoping review of available research. We searched 4 databases, PubMed, PsycInfo, Cumulative Index of Nursing and Allied Health, and Scopus. Evidence is most consistent for a direct association between social isolation, loneliness, and coronary heart disease and stroke mortality. However, data on the association between social isolation and loneliness with heart failure, dementia, and cognitive impairment are sparse and less robust. Few studies have empirically tested mediating pathways between social isolation, loneliness, and cardiovascular and brain health outcomes using appropriate methods for explanatory analyses. Notably, the effect estimates are small, and there may be unmeasured confounders of the associations. Research in groups that may be at higher risk or more vulnerable to the effects of social isolation is limited. We did not find any intervention studies that sought to reduce the adverse impact of social isolation or loneliness on cardiovascular or brain health outcomes. Social isolation and loneliness are common and appear to be independent risk factors for worse cardiovascular and brain health; however, consistency of the associations varies by outcome. There is a need to develop, implement, and test interventions to improve cardiovascular and brain health for individuals who are socially isolated or lonely.