Key result
Social isolation and low physical activity linked to ~58% higher mortality versus highly active, non-isolated peers.
Why the study?
Poor physical activity and excessive sedentary behaviour increase morbidity and mortality, but whether emerging social problems like loneliness and social isolation exacerbate these risks was not well defined.
Does social isolation or loneliness amplify the risk of mortality and cardiovascular disease associated with varying levels of physical activity and sedentary behavior in adults?
Cohort (n=497,544)
Yes
Does social isolation or loneliness amplify the risk of mortality and cardiovascular disease associated with varying levels of physical activity and sedentary behavior in adults?
Social isolation consistently amplifies the mortality risks associated with poor physical activity and sedentary behavior, highlighting the need to target socially isolated individuals in preventive public health strategies.
Social isolation may amplify mortality risk across activity levels; extends joint-risk observations but remains hypothesis-generating for interventions.
BACKGROUND: Poor physical activity and excessive sedentary behaviour are well-established risk factors for morbidity and mortality. In the presence of emerging social problems, including loneliness and social isolation, these risks may be even greater. We aimed to investigate the joint effects of social health and movement behaviours on mortality and cardiovascular disease (CVD). METHODS: 497,544 UK Biobank participants were followed for an average of 11 years. Loneliness and social isolation were measured via self-report. Physical activity was categorised around current World Health Organisation (WHO) guidelines as low (< 600 metabolic equivalent of task [MET]-mins/week), moderate (600 < 1200) and high (≥ 1200). Sedentary behaviour was classified as low (≤ 3.5 h/day), moderate (3.5 ≤ 5) and high (> 5.5). We derived 24 social health-movement behaviour combinations, accordingly. Mortality and hospitalisations were ascertained to May 2020 for all-cause and CVD mortality, and non-fatal cardiovascular events. RESULTS: Social isolation amplified the risk of both all-cause and CVD death across all physical activity and sedentary levels (hazard ratio, 95% confidence interval [HR, 95% CIs] for all-cause mortality; 1.58 [1.49 to 1.68] for low active-isolated vs. 1.26 [1.22 to 1.30] for low active-not isolated). Loneliness was only found to amplify the risk of death from cardiovascular disease among the high active and low sedentary participants. Loneliness and social isolation did not add to the risk of non-fatal cardiovascular events across most activity levels. CONCLUSION: The detrimental associations of poor physical activity and sedentary behaviour with mortality were consistently amplified by social isolation. Our study supports the need to target the socially isolated as a priority group in preventive public health strategies.
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Manera et al. (2022) conducted a cohort in Mortality and cardiovascular disease (n=497,544). Social isolation and low physical activity vs. Not isolated and high physical activity was evaluated on All-cause mortality (HR 1.58, 95% CI 1.49-1.68). Social isolation amplified the risk of all-cause mortality across all physical activity levels, with low active and isolated individuals having a 58% higher risk of death compared to high active and not isolated individuals (HR 1.58).
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