Social isolation, as evidenced by objective indicators such as having a small social network,
1 being unmarried,
2,3 participating in few activities with others,
4-6 or some combination of these,
7,8 has been associated with increased risk of dementia and cognitive decline in several prospective studies. In contrast, little is known about the association of dementia with emotional isolation, or loneliness, which refers to perceived social isolation and feeling disconnected from others, that is, to dissatisfaction with social interactions rather than their absence. Although loneliness is related to social isolation, the correlation is far from perfect.
9 The only previous study of which we are aware was based on brief measures of loneliness and cognition and had mixed results, with loneliness related to increased risk of cognitive decline in some analyses but not others.
10 Thus, as previously noted,
11 it is uncertain how much feeling alone (ie, loneliness), as distinct from being alone (ie, social isolation), contributes to risk of dementia in old age.