Mismatch between loneliness and social contact linked with higher risk of disease and death

New research using data from the English Longitudinal Study of Ageing shows that when people feel lonelier than expected given their level of social contact, their risk of several major health conditions and early death is higher.

A study using data from the English Longitudinal Study of Ageing has found that a gap between how lonely people feel and how socially connected they are is linked with a higher risk of serious illness and death.

The research, published in JAMA Network Open, analysed information from 7,845 adults aged 50 and over who took part in ELSA. Participants were followed for an average of 13.6 years through linked hospital and mortality records.

The study focused on what researchers call social asymmetry. This describes the difference between a person’s subjective experience of loneliness and their objective level of social isolation. Some people feel lonelier than their level of social contact would suggest, while others report relatively little loneliness despite limited contact.

Researchers classified participants according to this mismatch. People who felt lonelier than expected for their level of social connection were described as socially vulnerable.

During follow up, 2,775 participants died and many others developed major health conditions, including cardiovascular disease, chronic obstructive pulmonary disease and dementia. Death and long-term illness was more common among older individuals and people with risk factors. But in addition, the analysis showed that higher social asymmetry was associated with an increased risk of these outcomes.

Those in the socially vulnerable group had a higher risk of all cause mortality as well as cardiovascular disease, heart failure and chronic obstructive pulmonary disease compared with people whose loneliness and social contact were more closely aligned.

The findings suggest that looking at loneliness or isolation alone may not fully capture how social experiences affect health. Instead, the difference between the two may provide additional insight into who is at greater risk.

Lead author Dr Pei Qin (UCL Institute of Epidemiology & Health Care) said: “Our findings show that the mismatch between how lonely people feel and how socially connected they are may matter for health. Someone can appear socially connected but still experience strong feelings of loneliness, and this group may face higher health risks. We need to direct resources towards these more vulnerable individuals, so that they are better supported at older ages.”

Qin P, et al. (2026) Social asymmetry and risk of morbidity and mortality. JAMA Network Open. doi:10.1001/jamanetworkopen.2026.44926

Photo by Dmitriy Tarasenko