The Pathophysiology of Perceived Social Isolation: Effects on Health and Mortality

Adnan Bashir Bhatti, Anwar Ul Haq, Adnan Bashir Bhatti, Anwar Ul Haq

Abstract

Perceived social isolation (PSI) is a deficit in normal human social interaction, which has been associated with negative health outcomes. However, the precise mechanisms through which PSI influences human health are not fully known. This review aims at bringing out what is known about these pathways through which social isolation affects human health. We searched PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Psychological Information Database (PsycINFO), and Cochrane Library in addition to secondary references from primary journal articles for the most relevant and recent information concerning the research topic. The keywords used were perceived social isolation, loneliness, health outcomes, cardiovascular effects, neuroendocrine effects, depression, and cognitive decline, in animal and human populations. There are clear linkages between PSI and the cardiovascular system, neuroendocrine system, and cognitive functioning. PSI also leads to depression, cognitive decline, and sleep problems. The mechanisms through which PSI causes these effects are neural, hormonal, genetic, emotional, and behavioral. The effects of PSI on health are both direct and indirect. There is a complex interconnected network of pathways through which PSI negatively influences health. These hypothetical pathways using which the effects of PSI have been explained form the base on which further analyses can be carried out.

Keywords: loneliness; perceived social isolation; psi; social isolation.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1. Established and hypothesized pathways between…
Figure 1. Established and hypothesized pathways between social isolation, cardiovascular function, and cognitive function.

References

    1. The adaptive value of sociality in mammalian groups. Silk JB. Philos Trans R Soc Lond B Biol Sci. 2007;362:362–539.
    1. Deconstructing sociality, social evolution and relevant nonapeptide functions. Goodson JL. . Psychoneuroendocrinology. 2013;38:465–478.
    1. Perceived social isolation, evolutionary fitness and health outcomes: a lifespan approach. Hawkley LC, Capitanio JP. Philos Trans R Soc Lond B Biol Sci. 2015;370:1669.
    1. Association of higher cortical amyloid burden with loneliness in cognitively normal older adults. Donovan NJ, Okereke OI, Vannini P, Amariglio RE, Rentz DM, Marshall GA, Johnson KA, Sperling RA. JAMA Psychiatry. 2016;12:1230–1237.
    1. Social disconnectedness, perceived isolation, and health among older adults. Cornwell EY, Waite LJ. J Health Soc Behav. 2009;1:31–48.
    1. Social isolation: a conceptual and measurement proposal. Zavaleta D, Samuel K, Mills C. OPHI. 2014:0.
    1. Loneliness and risk of Alzheimer disease. Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, Tang Y, Bennett DA. Arch Gen Psychiatry. 2007;2:234–240.
    1. Adverse adolescent relationship histories and young adult health: cumulative effects of loneliness, low parental support, relationship instability, intimate partner violence, and loss. Adam EK, Chyu L, Hoyt LT, Doane LD, Boisjoly J, Duncan GJ, Chase-Lansdale PL, McDade McDade. J Adolesc Health. 2011;3:278–286.
    1. Loneliness in everyday life: cardiovascular activity, psychosocial context, and health behaviors. Hawkley LC, Burleson MH, Berntson GG, Cacioppo JT. . J Pers Soc Psychol. 2003;85:105–120.
    1. The development of loneliness from mid- to late adolescence: trajectory classes, personality traits, and psychosocial functioning. Vanhalst J, Goossens L, Luyckx K, Scholte RHJ, Engels RCME. . J Adolesc. 2013;36:1305–1312.
    1. Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Cacioppo JT, Hughes ME, Waite LJ, Hawkley LC, Thisted RA. Psychology and Aging. 2006;21:140–151.
    1. Loneliness is a unique predictor of age-related differences in systolic blood pressure. Hawkley LC, Masi CM, Berry JD, Cacioppo JT. Psychol Aging. 2006;21:152–164.
    1. Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women. Steptoe A, Owen N, Kunz-Ebrecht SR, Brydon L. . Psychoneuroendocrinology. 2004;29:593–611.
    1. Social isolation, loneliness, and all-cause mortality in older men and women. Steptoe A, Shankar A, Demakakos P, Wardle J. Proc. Natl. Acad. Sci. U.S.A. 2013;2013:5797–5801.
    1. Social isolation: a predictor of mortality comparable to traditional clinical risk factors. Pantell M, Rehkopf D, Jutte D, Syme SL, Balmes J, Adler N. . Am J Public Health. 2013;103:2056–2062.
    1. Social relationships and mortality risk: a meta-analytic review. Holt-Lunstad J, Smith TB, Layton JB. PLoS Med. 2010;7:0.
    1. Social isolation, cognitive decline, and cardiovascular disease risk. White CN, VanderDrift LE, Heffernan KS. Curr Opin Psychol. 2015;5:18–23.
    1. Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study): case-control study. Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, Blackett KN, Sitthi-amorn C, Sato H, Yusuf S. . Lancet. 2004;364:953–962.
    1. Social network, presence of cardiovascular events and mortality in hypertensive patients. Menendez-Villalva C, Gamarra-Mondelo MT, Alonso-Fachado A, Naveira-Castelo A, Montes-Martinez A. . J Hum Hypertens. 2015;29:417–423.
    1. Social isolation affects the development of obesity and type 2 diabetes in mice. Nonogaki K, Nozue K, Oka Y. . Endocrinology. 2007;148:4658–4666.
    1. Social isolation rearing induces mitochondrial, immunological, neurochemical and behavioural deficits in rats, and is reversed by clozapine or N-acetyl cysteine. Moller M, Du Preez JL, Viljoen FP, Berk M, Emsley R, Harvey BH. . Brain Behav Immun. 2013;30:156–167.
    1. Social isolation and stress-related cardiovascular, lipid, and cortisol responses. Grant N, Hamer M, Steptoe A. . Ann Behav Med. 2009;37:29–37.
    1. Psychosocial factors and heart rate variability in healthy women. Horsten M, Ericson M, Perski A, Wamala SP, Schenck-Gustafsson K, Orth-Gomer K. . Psychosom Med. 1999;61:49–57.
    1. Social isolation and adult mortality: the role of chronic inflammation and sex differences. Yang YC, McClintock MK, Kozloski M, Li T. J Health Soc Behav. 2013;54:183–203.
    1. Social network and coronary artery calcification in asymptomatic individuals. Kop WJ, Berman DS, Gransar H, Wong ND, Miranda-Peats R, White MD, Shin M, Bruce M, Krantz DS, Rozanski A. . Psychosom Med. 2005;67:343–352.
    1. Association between social isolation and left ventricular mass. Rodriguez CJ, Elkind MS, Clemow L, Jin Z, Di Tullio M, Sacco RL, Homma S, Boden-Albala B. Am J Med. 2011;124:164–170.
    1. Effects of social isolation on glucocorticoid regulation in social mammals. Hawkley LC, Cole SW, Capitanio JP, Norman GJ, Cacioppo JT. Horm Behav. 2012;62:314–323.
    1. Elevated macrophage migration inhibitory factor (MIF) is associated with depressive symptoms, blunted cortisol reactivity to acute stress, and lowered morning cortisol. Edwards KM, Bosch JA, Engeland CG, Cacioppo JT, Marucha PT. . Brain Behav Immun. 2010;24:1202–1208.
    1. Psychosocial modifiers of immunocompetence in medical students. Kiecolt-Glaser JK, GarnerW GarnerW, Speicher CE, Penn GM, Holliday JE, Glaser R. . Psychosom Med. 1984;46:7–14.
    1. Urinary cortisol levels, cellular immunocompetency, and loneliness in psychiatric inpatients. Kiecolt-Glaser JK, Ricker D, George J, Messick G, Speicher CE, Warren G, Ronald G. . Psychosom Med. 1984;46:15–23.
    1. Lonely traits and concomitant physiological processes: the MacArthur social neuroscience studies. Cacioppo JT, Ernst JM, Burleson MH, McClintock MK, Malarkey WB, Hawkley LC, Kowalewski RB, Paulsen A, Hobson JA, Hugdahl K, Spiegel D. . Int J Psychophysiol. 2000;35:143–154.
    1. Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women. Steptoe A, Owen N, Kunz-Ebrecht SR, Brydon L. . Psychoneuroendocrinology. 2004;29:593–611.
    1. Beta adrenergic blockade decreases the immunomodulatory effects of social disruption stress. Hanke ML, Powell ND, Stiner LM, Bailey MT, Sheridan JF. Brain Behav Immun. 2012;26:1150–1159.
    1. Social regulation of leukocyte homeostasis: the role of glucocorticoid sensitivity. Cole SW. Brain Behav Immun. 2008;22:1049–1065.
    1. The neuroendocrinology of social isolation. Cacioppo JT, Cacioppo S, Capitanio JP, Cole SW. . Annu Rev Psychol. 2015;66:733–767.
    1. Childhood loneliness as a predictor of adolescent depressive symptoms: an 8-year longitudinal study. Qualter P, Brown SL, Munn P, Rotenberg KJ. . Eur Child Adolesc Psychiatry. 2010;19:493–501.
    1. Adolescent loneliness and health in early adulthood. Goosby BJ, Bellatorre A, Walsemann KM, Cheadle JE. Sociol Inq. 2013;83:505–536.
    1. Social problem solving and suicidal behavior: ethnic differences in the moderating effects of loneliness and life stress. Hirsch JK, Chang ED, Jeglic EL. . Arch Suicide Res. 2012;16:303–315.
    1. Perceived social isolation and cognition. Cacioppo JT, Hawkley LC. . Trends Cogn Sci. 2009;13:447–454.
    1. Which social network or support factors are associated with cognitive abilities in old age? Gow AJ, Corley J, Starr JM, Deary IJ. . Gerontology. 2013;59:454–463.
    1. Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English longitudinal study of ageing. Shankar A, Hamer M, McMunn A, Steptoe A. . Psychosom Med. 2013;75:161–170.
    1. Giving in to feel good: the place of emotion regulation in the context of general self-control. Tice DM, Bratslavsky E. Psychol. 2000;11:149–159.
    1. Loneliness predicts reduced physical activity: cross-sectional and longitudinal analyses. Hawkley LC, Thisted RA, Cacioppo JT. . Health Psychol. 2009;28:354–363.
    1. Do lonely days invade the nights? Potential social modulation of sleep efficiency. Cacioppo JT, Hawkley LC, Berntson GG, Ernst JM, Gibbs AC, Stickgold R, Hobson JA. Sci. 2002;13:385–388.
    1. Loneliness impairs daytime functioning but not sleep duration. Hawkley LC, Preacher KJ, Cacioppo JT. Health. 2010;29:124–129.
    1. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Baumeister RF, Leary MR. . Psychol Bull. 1995;117:497–529.
    1. The consequences of pain: the social physical pain overlap on psychological responses. Riva P, Wirth JH, Williams KD. Eur J Soc Psychol. 2011;41:681–687.
    1. Loneliness, social isolation, and behavioral and biological health indicators in older adults. Shankar A, McMunn A, Banks J, Steptoe A. Health Psychol. 2011;30:377–385.
    1. Living Alone and Cardiovascular Risk in Outpatients at Risk of or With Atherothrombosis. Udell JA, Steg PG, Scirica BM, Smith SC Jr, Ohman EM, Eagle KA, Goto S, Cho JI, Bhatt DL. . Arch Intern Med. 2012;172:1086–1095.
    1. Weiss RS. Massachusetts: MIT Press; 1973. Loneliness: The experience of emotional and social isolation .

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere