University of California, San Francisco and the University of Alabama at Birmingham researchers have identified a link between social isolation and increased mortality among adults with chronic obstructive pulmonary disease (COPD), according to a study published in JAMA Internal Medicine.

Social isolation is a state of limited to no social contact. It has previously been associated with poor health outcomes and mortality among older adults aged 65 and above.

Approximately one in five individuals with COPD experience social isolation, twice the rate of older adults overall. Elevated rates of isolation may be the result of disease features such as breathlessness and reduced physical function, which can make normal everyday social engagement exhausting.

In the cohort study titled "Social Isolation and Mortality in Adults With Chronic Obstructive Pulmonary Disease," researchers looked into the mortality rates among the socially isolated with COPD.

Analyzing data from the 2006-2022 Health and Retirement Survey (HRS), the researchers focused on 1,241 community-dwelling adults aged 51 years or older who self-reported having COPD. Social isolation was measured using a scale that assessed factors including being unmarried, living alone, lack of social contact with children, family, or friends, and no community participation. Each factor contributed one point to a total score ranging from 0 to 6, with scores of 3 or more indicating social isolation.

Over a median follow-up of 4.4 years, 43.4% of participants (539 individuals) died. Among the cohort, 23.6% (293 individuals) were identified as socially isolated. Socially isolated participants exhibited a 35% higher risk of death compared to non-isolated counterparts, even after adjusting for population demographics, education, comorbidities, cognitive impairment, depression, and tobacco use.

Median survival time was significantly lower for socially isolated participants (7.0 years) than their non-isolated counterparts (9.1 years). The 5-year survival rate was 62.9% for the socially isolated group versus 71.1% for the non-isolated group.

Prior studies using HRS data reported a 2% absolute risk difference in 5-year survival due to isolation (93% for isolated versus 95% for non-isolated older adults). In contrast, the current study found an 8.3% difference within the COPD population. These findings suggest that the impact of social isolation on mortality among individuals with COPD is more pronounced than previously observed in the general older adult population.

The researchers hypothesize that COPD with social isolation may raise mortality risk by limiting participation in essential support needed to manage the debilitating symptoms, particularly after hospitalization or intensive care unit stays, where follow-up support plays a crucial role in recovery and disease management.

Given the high prevalence of social isolation among individuals with COPD, the study suggests that interdisciplinary efforts to reduce social isolation could complement existing disease-directed treatment strategies. Addressing social isolation may enhance well-being and health care access to manage COPD. Suggested interventions include group-based pulmonary rehabilitation, behavioral activation to promote self-efficacy, support groups, and community meal or exercise programs.

The researchers recommend that future studies explore strategies to reduce social isolation among COPD patients and assess whether these efforts can improve health outcomes.