Social isolation has been linked to a variety of adverse health outcomes, including cardiovascular disease. Researchers have attributed this association to the feelings of loneliness that accompany social isolation, but they have rarely assessed loneliness directly. In a sample of 180 older adults, feelings of loneliness and two kinds of social deficits that underlie loneliness& limited emotional support and limited companionship&were examined in relation to the likelihood of having a coronary condition. Potential physiological, behavioral, and affective mediators were examined as well. Greater loneliness was found to be associated with an increased probability of having a coronary condition, as were low levels of both emotional support and companionship. Mediators of these links were not identified, however, in this sample. These results underscore the value of examining the specific social deficits that underlie loneliness in investigations of the relation between loneliness and cardiovascular health in later life.
This is a preview of subscription content, log in to check access.
House JS, Landis, KR, Umberson, D: Social relationships and health.Science. 1988,241:540–545.
Seeman TE: Social ties and health: The benefits of social integration.Annals of Epidemiology. 1996,6:442–451.
Uchino BN, Cacioppo JT, Kiecolt-Glaser JK: The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health.Psychological Bulletin. 1996,119:488–531.
Green LR, Richardson DS, Lago T, Schatten-Jones EC: Network correlates of social and emotional loneliness in young and older adults.Personality and Social Psychology Bulletin. 2001,27:281–288.
Cassel J: The contribution of the social environment to host resistance.American Journal of Epidemiology. 1976,104: 253–286.
Cobb S: Social support as a moderator of life stress.Psychosomatic Medicine. 1976,38:300–314.
Berkman LF, Syme SL: Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents.American Journal of Epidemiology. 1979,109:684–694.
Greenwood DC, Muir KR, Packham CJ, Madeley RJ: Coronary heart disease: A review of the role of psychosocial stress and social support.Journal of Public Health and Medicine. 1996,18:221–231.
Seeman TE, Syme SL: Social networks and coronary artery disease: A comparative analysis of network structural and support characteristics.Psychosomatic Medicine. 1987,49:341–354.
Karlsson I, Berglin E, Pettersson G, Larsson PA: Predictors of chest pain after coronary artery bypass grafting.Scandinavian Cardiovascular Journal. 1999,33:289–294.
Berkman LF, Leo-Summers L, Horwitz R: Emotional support and survival after myocardial infarction: A prospective, population-based study of the elderly.Annals of Internal Medicine. 1992,117:1003–1009.
Orth-Gomér K, Undén A, Edwards M: Social isolation and mortality in ischemic heart disease: A 10-year follow-up study of 150 middle-aged men.Acta Medica Scandinavica. 1988,224:205–215.
Peplau LA, Perlman D: Perspectives on loneliness. In Peplau LA, Perlman D (eds),Loneliness: A Sourcebook of Current Theory, Research, and Therapy. New York: Wiley-Interscience, 1982, 1–20.
Russell DW, Cutrona CE, Rose J, Yurko K: Social and emotional loneliness: An examination of Weiss’s typology of loneliness.Journal of Personality and Social Psychology. 1984,6:1313–1321.
Chappell NL, Badger M: Social isolation and well-being.Journal of Gerontology: Social Sciences. 1989,44:S169-S176.
Antonucci TC, Johnson EH: Conceptualization and methods in social support theory and research as related to cardiovascular disease. In Shumaker SA, Czajkowski SM (eds),Social Support and Cardiovascular Disease. New York: Plenum, 1994, 32–36.
Herlitz J, Wiklund I, Sjöland H, et al.: Relief of symptoms and improvement of quality of life five years after coronary artery bypass grafting in relation to preoperative ejection fraction.Quality of Life Research. 2000,9:467–476.
Weiss RS: The provisions of social relationships. In Rubin Z (ed),Doing Unto Others. Englewood Cliffs, NJ: Prentice Hall, 1974, 17–26.
Rook KS: Social relationships as a source of companionship: Implications for older adults’ psychological well-being. In Sarason BR, Sarason IG, Pierce GR (eds),Social Support: An Interactional View. New York: Wiley, 1990, 210–250.
Russell D: The measurement of loneliness. In Peplau LA, Perlman D (eds),Loneliness: A Sourcebook of Current Theory, Research, and Therapy. New York: Wiley, 1982, 81–104.
Gupta V, Korte C: The effects of a confidant and peer group on the well-being of single elders.International Journal of Aging and Human Development. 1994,39:293–302.
Rook KS: Social support versus companionship: Effects on life stress, loneliness, and evaluations by others.Journal of Personality and Social Psychology. 1987,52:1132–1147.
Holmén K, Ericsson, K, Winblad B: Social and emotional loneliness among non-demented and demented elderly people.Archives of Gerontology and Geriatrics. 2000,31:177–192.
Andersson L: Intervention against loneliness in a group of elderly women: An impact evaluation.Social Science and Medicine. 1985,20:355–364.
Cacioppo JT, Ernst JM, Burleson, MH, et al.: Lonely traits and concomitant physiological processes: The MacArthur social neuroscience studies.International Journal of Psychophysiology. 2000,35:143–154.
Mahon NE, Yarcheski A, Yarcheski TJ: Social support and positive health practices in young adults: Loneliness as a mediating variable.Clinical Nursing Research. 1998,7:292–308.
Lewis MA, Rook KS: Social control in personal relationships: Impact on health behaviors and psychological distress.Health Psychology. 1999,18:63–71.
Ernst JM, Cacioppo JT: Lonely hearts: Psychological perspectives on loneliness.Applied and Preventive Psychology. 1999,8:1–22.
Cohen S: Psychosocial models of the role of social support in the etiology of physical disease.Health Psychology.1988,7:269–297.
U.S. Bureau of theCensus: Current populationreports (P20-532). The Older Population in the United States. Washington, DC: U.S. Government Printing Office, 1999.
Peplau LA, Bikson TK, Rook KS, Goodchilds J: Being old and living alone. In Peplau LA, Perlman D (eds),Loneliness: A Sourcebook of Current Theory, Research and Therapy. New York: Wiley-Interscience, 1982, 327–347.
Rook KS: Emotional health and positive versus negative social exchanges: A daily diary analysis.Applied Developmental Science. 2001,5:86–97.
Rook KS, Sorkin D: Fostering social ties through a volunteer role: Implications for older-adults’ psychological health. Manuscript submitted for publication.
Rook KS, Thuras RD, Lewis MA: Social control, health-risk-taking,and psychological distress.Psychology and Aging. 1990,5:327–334.
Russell DW, Peplau LA, Cutrona CE: The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence.Journal of Personality and Social Psychology. 1980,39:472–480.
Russell DW: UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure.Journal of Personality Assessment. 1996,66:20–40.
Martin P, Hagberg B, Poon LW: Predictors of loneliness in centenarians: A parallel study.Journal of Cross-Cultural Gerontology. 1997,12:203–224.
Wiseman H: Interpersonal relatedness and self-definition in the experience of loneliness during the transition to university.Personal Relationships. 1997,4:285–299.
Shaver P, Brennan K: Measures of depression and loneliness. In Robinson J, Shaver P, Wrightsman L (eds),Measures of Personality and Social Psychological Attitudes. San Diego, CA: Academic, 1991, 195–289.
Barrera M: Distinctions between social support concepts, measures, and models.American Journal of Community Psychology. 1986,14:413–445.
Cohen S, Wills TA: Stress, social support, and the buffering hypothesis.Psychological Bulletin. 1985,98:310–357.
McCallister L, Fischer CS: A procedure for surveying personal networks.Sociological Methods and Research. 1978,7:131–148.
Rook KS: Assessing the health-related dimensions of older adults’ social relationships. In Lawton MP, Teresi J (eds),Annual Review of Gerontology and Geriatrics (Vol. 14). New York: Springer, 1994, 142–181.
Antonucci TC, Akiyama H: Social networks in adult life and a preliminary examination of the convoy model.Journal of Gerontology. 1987,42:519–527.
Krause N: Assessing change in social support during late life.Research on Aging. 1999,21:539–569.
Morgan DL, Neal MB, Carder PC: The stability of core and peripheral networks overtime.Social Networks. 1997,19:9–25.
Suitor JJ, Pillemer K: Support and interpersonal stress in the social networks of married daughters caring for parents with dementia.Journal of Gerontology: Social Sciences. 1993,48:S1-S8.
Thompson EH, Futterman AM, Gallagher-Thompson D, Rose JM, Lovett SB: Social support and caregiving burden in family caregivers of frail elders.Journal of Gerontology: Social Sciences. 1993,48:S245-S254.
Radloff L: The CES-D scale: A self-report depression scale for research in the general population.Applied Psychological Measurement. 1977,1:385–401.
Pachana, NA, Gallagher-Thompson D, Thompson LW: Assessment of depression. In Lawton MP, Teresi, JA (eds),Annual Review of Gerontology and Geriatrics (Vol.14). New York: Springer, 1994, 234–256.
Kammann R, Flett R: Affectometer 2: A scale to measure current level of general happiness.Australian Journal of Psychology. 1983,35:259–265.
Pennix BWJH, van Tilberg T, Kriegsman DMW, et al.: Social network, social support, and loneliness in older persons with different chronic diseases.Journal of Aging and Health. 1999,11:151–168.
Møller L, Kristensen TS, Hollnagel H: Self-rated health as a predictor of coronary heart disease in Copenhagen, Denmark.Journalof EpidemiologyandCommunityHealth. 1996,50:423–428.
Baron, RM, Kenny, DA: The moderator-mediator variables distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology. 1986,51:1173–1182.
Møller L, Kristensen TS: Plasma fibrinogen and ischemic heart disease risk factors.Arteriosclerosis and Thrombosis. 1991,11: 344–350.
Uchino BN, Holt-Lunstad J, Uno D, Betancourt R, Garvey TS: Social support and age-related differences in cardiovascular function: An examination of potential mediators.Annals of Behavioral Medicine. 1999,21:135–142.
Geller, J: Loneliness: An overlooked and costly health risk factor.Minnesota Medicine. 2000,83:48–51.
This research was supported by Grant AG03975 from the National Institute on Aging.
We thank Martha Ryan Pedersen and Paul Thuras for their invaluable help in overseeing the data collection and data management, and we thank a large group of undergraduate students who provided assistance with data collection and data coding.
About this article
Cite this article
Sorkin, D., Rook, K.S. & Lu, J.L. Loneliness, lack of emotional support, lack of companionship, and the likelihood of having a heart condition in an elderly sample. ann. behav. med. 24, 290–298 (2002). https://doi.org/10.1207/S15324796ABM2404_05
- Social Support
- Emotional Support
- Behavioral Medicine
- Network Member
- Social Deficit