For the first time, researchers from the nationwide nursing project, DenHeart, have studied the health consequences of loneliness for patients with various forms of heart disease, and a clear picture is developing that loneliness can have serious consequences.
"Loneliness is more common today than ever before, and more and more people are living alone. As healthcare professionals, we need to take this into consideration when assessing patient risks," said Anne Vinggaard Christensen, the first author of the study and a PhD student at the Heart Centre at Rigshospitalet.
Results from 13,463 heart patients
Previous research has proved a connection between loneliness/social isolation and cardiovascular disease. The new study from Rigshospitalet now establishes that loneliness can be harmful, and that feeling lonely also entails a higher risk of poor health than just living alone:
"The results from the 13,463 Danish patients with ischemic heart disease, arrhythmia, heart failure and heart valve disease clearly show that the risk of poorer health is strongly connected with loneliness," said Anne Vinggaard Christensen and continued:
"Loneliness is a strong predictor of death, poor mental health and lower quality of life among heart patients, and a much stronger predictor than living alone, both among men and women," Anne Vinggaard Christensen concluded in the study, which is expected to be published later in the summer.
The research results were recently presented at the international nursing congress, EuroHeartCare 2018 in Dublin, where Anne Vinggaard Christensen could reveal that a poor social network among people suffering from heart disease is associated with poorer health. Since then, the news about loneliness being a risk factor has spread around the world.
A question of loneliness
In the study, data from national registers was coupled with data from the DenHeart study, in which all patients discharged from one of the five heart centres in Denmark between April 2013 and April 2014 were asked to fill out a questionnaire about their physical and mental health, lifestyle factors, such as smoking, and social network. Social network was measured using register data on whether the patients lived together with anyone, and a question from the questionnaire:
"Are you ever alone, even though you'd rather be with others?"
"The study shows that responses to a single question regarding loneliness contain important health information, and that there is a difference in what patients experience. They can live alone and not feel lonely, while others feel lonely, even though they live with someone," explained Anne Vinggaard Christensen.
Loneliness was associated with poorer health among all patients, regardless of their type of heart disease, and this is even after considering age, level of education, other diseases, BMI, smoking, alcohol intake and whether patients take their medicine. Loneliness was associated with twice the risk of dying for both men and women. Moreover, both men and women who feel lonely had a two to three times higher risk of reporting symptoms of anxiety and depression, and they had a significantly poorer quality of life compared with those who did not feel lonely.
Rigshospitalet has initiated a new project, HeartBuddy, to strengthen social networks for heart patients and make them more resilient to lifestyle changes and to dealing with life as a heart patient.
The nationwide DenHeart study is headed by Rigshospitalet, and data was collected from the five major heart centres in Denmark (Rigshospitalet, Herlev-Gentofte Hospital, Odense University Hospital, Aarhus University Hospital and Aalborg University Hospital) in collaboration with the National Institute of Public Health at the University of Southern Denmark. The study was funded by the Danish heart centres, the Novo Nordisk Foundation, the Health Insurance Foundation and the Family Hede Nielsen Foundation.