Social isolation, social support, loneliness and cardiovascular disease risk factors: A cross-sectional study among older adults

Int J Geriatr Psychiatry. 2021 Nov;36(11):1795-1809. doi: 10.1002/gps.5601. Epub 2021 Jul 21.


Background: Social health reflects one's ability to form interpersonal relationships. Poor social health is a risk factor for cardiovascular disease (CVD), however an in-depth exploration of the link through CVD risk factors is lacking.

Aim: To examine the relationship between social health (social isolation, social support, loneliness) and CVD risk factors among healthy older women and men.

Methods: Data were from 11,498 healthy community-dwelling Australians aged ≥70 years from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and the ASPREE Longitudinal Study of Older Persons sub-study. Ten-year CVD risk was estimated using the Atherosclerotic CVD Risk Scale (ASCVDRS) and the Framingham Risk Score (FRS).

Results: Physical inactivity and experiencing depressive symptoms were the only CVD risk factors that consistently differed by all three social health constructs. Loneliness was associated with greater ASCVDRS (women: β = 0.01, p < 0.05; men: β = 0.03, p < 0.001), social isolation with greater FRS (women: β = 0.02, p < 0.01; men: β = 0.03, p < 0.01) and the social health composite of being lonely (regardless of social isolation and/or social support status) with greater ASCVDRS (women: β = 0.01, p = 0.02; men: β = 0.03, p < 0.001). Among men, loneliness was also associated with greater FRS (β = 0.03, p < 0.001) and social support with greater ASCVDRS (β = 0.02, p = 0.01). Men were more socially isolated, less socially supported and less lonely than women.

Conclusion: Social isolation, social support and loneliness displayed diverse relationships with CVD risk factors and risk scores, emphasising the importance of distinguishing between these constructs. These findings inform on potential avenues to manage poor social health and CVD risk among older adults.

Keywords: aged; aged, 80 and over; aging; cardiovascular disease; depression; depressive symptoms; exercise; geriatrics; loneliness; physical activity; social isolation; social support.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Cardiovascular Diseases* / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Loneliness
  • Longitudinal Studies
  • Male
  • Risk Factors
  • Social Isolation*
  • Social Support