Persistent social isolation was associated with accelerated biological ageing (β=+0.412 years) and higher all-cause mortality (aHR 1.66; 95% CI 1.40-1.96) compared to persistent connection.
Cohort (n=17,663)
Does social isolation accelerate biological ageing assessed by AI-ECG and increase mortality in individuals without significant cardiovascular disease?
Persistent social connection is associated with slower biological ageing as measured by AI-ECG and lower all-cause mortality compared to social isolation.
Hazard Ratio: 1.66 (95% CI 1.4–1.96)
p-value: p=<0.001
AIMS: Social isolation (SI) is associated with a higher risk of cardiovascular disease (CVD). One mechanism linking SI and CVD is accelerated biological ageing, which can be assessed using artificial intelligence-enabled electrocardiography (AI-ECG). We investigated whether longitudinal changes in SI status are associated with changes in biological ageing patterns. METHODS AND RESULTS: A retrospective longitudinal cohort study including 17 663 individuals without significant CVD who completed ≥2 Berkman and Syme Social Network Index and had paired ECGs within 1 year of each questionnaire. Longitudinal SI status was defined by comparing baseline and follow-up SI status. Ageing trends were assessed using Δage-gap, defined as the change in the gap between AI-ECG-predicted age and chronological age from baseline to follow-up. Linear regression models predicting Δage-gap and survival analyses with Kaplan-Meier and multivariable Cox regression for all-cause mortality were performed. Persistently connected individuals were older 63.1 (52.1, 70.6) years and had a higher prevalence of hyperlipidaemia and hypertension, yet demonstrated more favourable ageing trajectories. Similarly, those who became connected showed a non-significant attenuation of accelerated ageing. In multivariable linear regression, being persistently isolated β = +0.412 years, P < 0.001 or becoming isolated β = +0.438 years, P = 0.012 was associated with accelerated ageing compared to being persistently connected. In survival analyses, becoming isolated (aHR = 1.94, 95% CI = 1.53-2.46, P < 0.001) and being persistently isolated (aHR = 1.66, 95% CI = 1.40-1.96, P < 0.001) were associated with significantly higher all-cause mortality, independent of chronological age and comorbidities. CONCLUSION: Persistent social connection is associated with slower biological ageing and lower mortality. The effects of SI on ageing and survival appear to be potentially reversible, calling for a prospective study to evaluate interventions aimed at improving both the social and biological burden of SI.
Manzato et al. (2026) conducted a cohort in No significant cardiovascular disease (n=17,663). Persistent social isolation vs. Persistent social connection was evaluated on all-cause mortality (aHR 1.66, 95% CI 1.40-1.96, p=<0.001). Persistent social isolation was associated with accelerated biological ageing (β=+0.412 years) and higher all-cause mortality (aHR 1.66; 95% CI 1.40-1.96) compared to persistent connection.