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Chronic Loneliness Associated With Hiked Stroke Risk in Older Adults

Chronic loneliness was associated with higher stroke risk, independent of other factors, according to recent prospective cohort study results published in eClinicalMedicine. 

“Addressing loneliness may have an important role in stroke prevention, and repeated assessments of loneliness over time may help identify those particularly at risk,” the study authors noted.

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Researchers examined data from the Health and Retirement Study during 2006–2018 that included U.S. adults 50 years and older who were stroke-free at baseline. To measure change in loneliness over time, researchers looked at participants who were stroke-free throughout the exposure measurement period. Loneliness was measured using the 3-item Revised UCLA Loneliness Scale, and researchers constructed loneliness scores (range 3–9), dichotomized loneliness measures (high vs low using a >6 cutoff), and loneliness patterns across 2 time points (consistently low, remitting, recent onset, consistently high). Cox regression models were used to estimate associations of baseline loneliness (N = 12,161) with incident stroke over a 10–12-year period, and loneliness change patterns (N = 8936) with incident stroke over a subsequent 6–8-year period, adjusting for demographics, health behaviors, and health conditions.

Researchers found that higher loneliness scores at baseline were associated with incident stroke for continuous (hazard ratio [HR]: 1.05, 95% confidence interval [CI]: 1.01–1.08) and dichotomized (HR: 1.25, 95% CI: 1.06–1.47) loneliness measures. This association continued even after adjustment for social isolation. Participants with a consistently high loneliness pattern over time had significantly higher incident stroke risk (HR: 1.56, 95% CI: 1.11–2.18) after adjusting for both social isolation and depressive symptoms. 

Authors noted that their study may have a few limitations. For one, since the sample was only older adults in the U.S., results may not be generalizable to other populations. Also, the length of the studied period of time may limit results—researchers used a 4-year exposure window to examine the effects of loneliness on stroke, which they say may not be “sufficient to ascertain the role of loneliness change in the etiology of stroke.”

“Future studies should examine more comprehensive loneliness trajectories over time to examine whether the association is sustained,” authors concluded, “examine the underlying mechanisms between loneliness and incident stroke, and whether interventions targeting loneliness are effective in preventing stroke.”

Reference 
Soh Y, Kawachi I, Kubzansky LD, et al. Chronic loneliness and the risk of incident stroke in middle and late adulthood: a longitudinal cohort study of U.S. older adults. Published online June 24, 2024. doi.org/10.1016/j.eclinm.2024.102639

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