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Associations of loneliness and social isolation with cardiovascular and metabolic health: a systematic review and meta-analysis protocol.

ABSTRACT: BACKGROUND:A growing number of studies suggest that social isolation and loneliness are associated with premature mortality and are more prevalent among people with mental illness than in the general population, outlining many potential paths to disease still to be elucidated. The purpose of this meta-analysis is to examine the relationship between loneliness, social isolation, and established cardiovascular/metabolic risk factors and disorders, especially in severe mental illness, and to account for potential heterogeneity in the literature. METHODS/DESIGN:Studies that report measures of loneliness and/or social isolation along with cardiovascular/metabolic risk factors will be identified. PubMed, EMBASE (through Ovid SP), Scopus, and PsycINFO (through Ovid SP) will be searched, along with citation lists of retrieved articles and the Cochrane Database of Systematic Reviews. Grey literature will be searched using Google Scholar. Data will be extracted from eligible studies for a random effects meta-analysis. For each study, a summary effect size, heterogeneity, risk of bias, publication bias, and the effect of categorical and continuous moderator variables will be determined. DISCUSSION:This proposed systematic review and meta-analysis will identify and synthesise evidence to determine if there is an association between loneliness, social isolation, and cardiovascular/metabolic risk factors, with a special focus on severe mental illnesses. The results will help determine links and promising avenues of further research. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42018111911.

SUBMITTER: Winterton A

PROVIDER: S-EPMC7199368 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Associations of loneliness and social isolation with cardiovascular and metabolic health: a systematic review and meta-analysis protocol.

Winterton Adriano A Rødevand Linn L Westlye Lars T LT Steen Nils Eiel NE Andreassen Ole A OA Quintana Daniel S DS

Systematic reviews 20200504 1

<h4>Background</h4>A growing number of studies suggest that social isolation and loneliness are associated with premature mortality and are more prevalent among people with mental illness than in the general population, outlining many potential paths to disease still to be elucidated. The purpose of this meta-analysis is to examine the relationship between loneliness, social isolation, and established cardiovascular/metabolic risk factors and disorders, especially in severe mental illness, and t ...[more]

PMID: 32366295

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Project description:BACKGROUND:The health impacts of loneliness and social isolation among older adults are widely acknowledged. Despite this, there is no consensus on the possible causal nature of this relationship, which could undermine effectiveness of interventions. One body of thought is that loneliness and social isolation affect health-related behaviours to indirectly damage health. However, there has not been any systematic assessment of the association between loneliness and social isolation and health-related behaviours which considers the possible impact from confounding factors and the causal direction of this association. METHODS/DESIGN:The research will comprise a systematic review and meta-analysis to address the evidence gap. EMBASE, MEDLINE, PSYCINFO, CINAHL, SocIndex, Scopus and Web of Science will be systematically searched for quantitative observational studies considering an association between loneliness/social isolation and key health-related behaviours in older adults. Two reviewers will independently check the study titles and abstracts for eligibility. Included studies will be critically appraised using Newcastle-Ottawa Scale by the lead author and checked by the second reviewer. Discrepancies in eligibility or quality assessment will be resolved via discussion or referral to a third reviewer. Results will be synthesised and reported in accordance with the Centre for Reviews and Dissemination (CRD) guidelines. This will be in the form of a descriptive summary, risk of bias assessment together with a meta-analysis and sub-group analyses (for covariate adjusted results) where sufficient heterogeneity of results is established. Finally, any associations identified will be analysed using the Bradford-Hill criteria to explore causal relationships which, if they exist, will be reported by means of a computed causations score. DISCUSSION:This review aims to assess the extent and causal nature of associations between loneliness/social isolation and health-related behaviours among older adults. This data will provide a comprehensive overview of the quality of the evidence base to inform stakeholders in tackling the growing public health challenges arising from loneliness/social isolation in ageing populations. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42017020845.

Project description:BackgroundPoor parental bonding in childhood has been associated with loneliness in younger populations. Whether these associations persists into middle and older adulthood is unclear. Additionally, given the overlapping relationship between loneliness and social isolation we sought to explore the role of social isolation in any associations present i.e. are those reporting worse parental bonding lonely due to less connections or are they more likely to be lonely regardless of isolation.MethodsAnalysis of a nationally representative longitudinal sample of adults aged 50 and over from the English Longitudinal Study of Ageing was undertaken. The current analysis was based on data for core participants across waves 3[2006/7] to 8[2016/17] with missing data across waves leading to analytical samples ranging from 4384 to 5173. Multivariate adjusted multinomial regression models were used to assess associations between parental bonding [PBI], isolation [score derived from data on living alone, frequency of contact with friends, family and children, and whether or not participate in social organisations] and loneliness [R-UCLA].ResultsParental bonding scores were associated with later life loneliness according to overall PBI score [RRR .93 95%CI .92-.95], care [RRR .90 95%CI .88-.92] and overprotection [RRR 1.11 95%CI 1.08-1.14] subscale scores as well as when separated into maternal and paternal scores, with effects larger in relation to chronic loneliness. Parental bonding scores were also associated with isolation in later life, with the exception of maternal overprotection which was non-significant. The addition of isolation to the loneliness models however had no impact on associations indicating that isolation is not a mediator of the association between parental bonding and later life loneliness.ConclusionsAssociations between parental bonding and loneliness do persist into middle and older adulthood and were in line with hypothesis stronger for more chronic loneliness. Isolation did not explain these associations and those reporting more negative parental bonds were more likely to be lonely regardless of isolation.

Dataset Information

Associations of loneliness and social isolation with cardiovascular and metabolic health: a systematic review and meta-analysis protocol.

Publications

Associations of loneliness and social isolation with cardiovascular and metabolic health: a systematic review and meta-analysis protocol.

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