Measuring isolation and loneliness factor for broad-based morbidity and mortality The de Jong-Gierveld loneliness scale and the (Holt-Lunstad et al. 2010). What was especially UCLA loneliness scale (see Appendix 1) are surprising was that social isolation was found widely used to measure loneliness and neither to be as strong a risk factor for morbidity and have any explicit references to loneliness. Unlike mortality as smoking, obesity, sedentary lifestyle, loneliness, for which a number of measures have and high blood pressure (House et al. 1988). In been developed and are widely used, “there are a more recent research project carried out in the no universally accepted measures or established UK, it was found that mortality was higher among criteria for measuring social isolation or its more socially-isolated and lonely participants, but severity” (Grenade and Boldy 2007). The English social isolation was more significantly associated Longitudinal Study of Aging (ELSA) uses a simple with mortality than loneliness, after adjusting for index to measure social isolation, but it is not demographic factors and baseline health (Steptoe clear how robust it is (see Appendix 1). et al. 2013). Surveys have been, and can be, used to The impact of loneliness on cognition has also measure loneliness. However, some research been assessed. Perhaps the most striking finding suggests that levels of reported loneliness will in this literature is the breadth of emotional differ depending on how the data is collected, and cognitive processes and outcomes that e.g. surveys versus in-depth interviews (e.g. seem susceptible to the influence of loneliness. Victor et al. 2003) or aggregate measures versus Loneliness has been associated with personality self-rating scales, i.e. people are less likely to disorders and psychoses, suicide, impaired say they are lonely unless they are experiencing cognitive performance and cognitive decline severe loneliness. This is less of an issue if the over time (Shankar et al. 2013), increased same instrument and method is consistently used risk of dementia (Holwerda et al. 2014), and throughout a research project, but it makes it increases in depressive symptoms (Hawkley and difficult to compare results across projects. Cacioppo 2010: 219). In fact, Holwerda and colleagues (2014) found that people experiencing Consequences of isolation a high degree of loneliness were potentially and loneliness twice as likely to develop Alzheimer’s as those Research has consistently demonstrated the experiencing a lower degree of loneliness. health-damaging effects of social isolation and As Hawkley and Cacioppo point out, “these loneliness, and the health-promoting effects of data suggest that a perceived sense of social social support. connectedness serves as a scaffold for the self A growing body of longitudinal research indicates – damage the scaffold and the rest of the self that loneliness predicts increased morbidity and begins to crumble” (2010: 219). mortality (Hawkley and Cacioppo 2010: 219). Loneliness may also impact on the body’s The effects of loneliness seem to accrue over capacity to restore itself. According to some time to accelerate physiological ageing. For research, the same amount of sleep has instance, the greater the number of measurement fewer health benefits in individuals who feel occasions at which participants were lonely, the more socially isolated and poor sleep further higher the cardiovascular health risk in young exacerbates feelings of social isolation. This adulthood. Similarly, loneliness was associated recursive loop operates outside of consciousness with increased blood pressure and other and speaks to the difficulty of trying to manage symptoms in a population-based sample of loneliness (Hawkley and Cacioppo 2010: 219). middle-aged adults. Loneliness also has a strong relationship with low Social isolation also has damaging effects. Social personal well-being ratings. People who report isolation has been found to be a significant risk feeling lonely are almost 10 times more likely to Isolation and loneliness 11