THEY are the missing elderly, lost very often in plain sight.

Our neighbours, perhaps even our own relatives, isolated by a loss of social networks or mobility or by increasingly fragmented family structures.

Campaigners claim there are more than a million “missing” over-65s people over the age of 65across the UK who are chronically lonely.

A 2015 study carried out in Utah memorably compared the health risks from loneliness to the harm suffered by someone who smokes 15 cigarettes a day. Other studies have claimed it is more deadly than obesity.

In terms of direct health effects, it has been associated with higher risks of depression and suicide, dementia and high blood pressure.

Medics at York University found last year that loneliness makes people more likely to suffer from heart disease and stroke.

American researchers say that lonely people are nearly twice as likely to die early as those whose social supports are strong.

According to Age Scotland, 40,000 older people in Scotland spent Christmas alone and 100,000 are routinely isolated or lonely.

The Campaign To End Loneliness (CtEL), launched in 2011 by a coalition of charities working with older people, says we cannot afford to be complacent about the problem and the economic and the moral costs of doing nothing are simply too high.

Old people themselves, however, may not all agree.

A poll for The Herald by BMG Research found just 27 per cent of over-65s admitted to feeling lonely from time to time, or more often, compared with 59 per cent of people in the 16-34 age group.

But the campaign says loneliness is a silent epidemic.

A separate survey by CtEL, carried out via the networking website Gransnet, found that more than half of those who described themselves as lonely (56 per cent) had never talked about their loneliness to anyone, most saying those around them would be surprised or even astonished to hear they feel lonely.

Dr Kellie Payne, CtEL learning and research manager, says several risk factors converge when people reach and pass retirement age.

“Retirement itself can lead to isolation, people are more likely to suffer bereavement, while health conditions can mean they are less mobile and so less able to go and see people” she says.

“Loneliness is a public health issue, it is linked to early mortality.”

The campaign received £2.7 million from the Big Lottery Fund in January to fund a national initiative to reduce loneliness, initially focused on five sites across the UK, including Glasgow.

The project will explore ways to reduce loneliness, and includes a drive to get the public to pledge 250,000 acts of kindness such as regular phone calls and volunteer work in the community.

Dr Payne says businesses must do more, including assessing whether their own employees and customers may be lonely.

CtEL is also involved in advising the Scottish Government on a planned loneliness strategy. “We want to see support services to create age-friendly communities,” Dr Payne explained.

“These could include befriending networks and direct interventions, improved use of transport and technology, and we want to involve businesses.”

Others are also putting pressure on the government to do more, including Voluntary Health Scotland, which is collaborating with the charities Befriending Networks and British Red Cross to influence ministers’ forthcoming national social isolation strategy.

Although this is part of the Government’s current programme for government at Holyrood, little detail has yet emerged, although Social Justice Secretary Alex Neil announced a £300,000 Social Isolation and Loneliness Fund last month.

Alec Nixon, a former post office manager knows how easily it can creep up on you.

The 77-year-old was forced to retire early due to ill health 20 years ago and for 19 of those he kept active by volunteering, usually to help out at sporting events.

An Olympic “gamesmaker”

in London in 2012, and then at the Paralympics, he also volunteered at the Glasgow 2014 Commonwealth Games, and has helped run the Great Scottish Run. Now ill health has put an end to his volunteering, and the mild dementia suffered by his wife Irene, also 77, has left him more isolated.

But the couple are staving off loneliness by regular attendance at a local day centre close to their home in Knightswood, Glasgow.

Derek Young, Age Scotland’s senior policy officer, says the key issues are reaching lonely people, understanding why they are lonely and then intervening to involve everyone from charities, businesses, families and the wider community to help them develop new and existing connections.

Health and social care integration boards should include specific actions and targets in their planning to tackle loneliness and isolation, Mr Young says.

Finding those affected could involve a national publicity campaign, but could also involve targeting more help at trigger points which carry a loneliness “risk” – bereavement, divorce, retirement, or a physical or cognitive impairment which limits mobility or communication.

“By definition, lonely people are less likely to be spotted because there are fewer people in their lives,” he says.