By Professor Woody Caan, Editor, Journal of Public Mental Health

THERE are two dimensions to loneliness. There is the objective sense of social isolation where people have few social contacts, and as we get older that becomes more common. Then there is subjective sense of feeling alone, abandoned and neglected.

Loneliness is a killer, it raises your chances of dying as an old person. People who are isolated are more likely to die in any given year and they are also more susceptible to two types of ill health: cardiovascular disease and depression, both of which are big problems in Scotland.

Isolation tends to get worse with age. We live in a society where older people are very much left to their own resources.

The Mental Health Foundation is concerned about what happens to older people when they leave hospital, and we should have a more active system for looking after these people. I did some work on people with an average age of 82 leaving a hospital in Cambridge. If they had one faceto-face contact with a friend or relative once a week, which was the threshold, they were still alive around six months after returning home.

Of the people who were sent home with no friend or family contact, roughly half were dead within six months.

They were a similar age with similar health problems.

Professionals were going into all of their homes and making sure they had food, with a very low level of contact that was about the same across the two groups.

Social care doesn’t necessarily get the chance to get to know the people, and that contact wasn’t enough to keep the isolated group alive.

So if you live to your 80s it’s important to maintain regular face-to-face contact with a relative or a friend.

I’m a big believer in mutual aid. There was a study done in Carlisle which found when older people came together to do something such as gardening, dancing or singing, this counteracts loneliness and gives a more positive sense of wellbeing to the person’s whole life. They look forward all week to seeing their new friends and doing something together.

Gardening had the biggest effect, because they were doing something active.

If older people have the opportunity to get together they may find the remedy to many of their own problems, but they may need a safe place to meet and the right transport.

There is another approach by a professor at Harvard who found a difference between generations. Americans in their 90s have such a sense of public spirit, turn out to vote, volunteer and get to know their neighbours, because they went through the Second World War and they know how to pull together with strangers.

People in their 60s, are on average more selfish and may do badly in old age because we haven’t built up skills with getting on with strangers.

I have mixed views on the impact on social media. I published a study recently of someone with 500 Facebook friends who described their life as lonely.

It fulfils a function, but it’s a poor substitute for friendship and belonging at all ages.

Professor Caan is editor of the Journal of Public Mental Health.