Older adults who experience chronic loneliness face a 56% higher risk of stroke than those who are not lonely, according to a new study from the Harvard T.H. Chan School of Public Health .

Surgeon General Dr. Vivek Murthy called attention last year to a nationwide loneliness and social isolation epidemic , warning that a lack of social connection increases the risk of premature death by more than 60%. Now, Harvard researchers say they are among the first to explore the link between changes in loneliness and stroke risk over time.

The study authors had 12,161 adults 50 and older who had never had a stroke share information about their loneliness. Four years later, the 8,936 people still participating in the study answered the same questions. They were divided into four groups based on both results — “consistently low” (those who twice scored low on the loneliness scale); “remitting” (those who scored high the first time and low the second time); “recent onset” (those who scored low initially and high at follow-up); and “consistently high” (those who scored high both times).

During the eight-year follow-up period, 601 strokes were recorded among the 8,936 participants. Stroke is the fifth leading cause of death in the US. The researchers found that the “consistently high” loneliness group had a 56% higher risk of stroke than the “consistently low” group.

Those in the other two groups — “remitting” and “recent onset” — did not have an elevat.