inflammatory disease in individuals who experience chronically high levels of loneliness.”
The effects of loneliness are not limited to an increase in health- threatening processes. Loneliness has also been associated with a decrease in health-restoring processes. Sleep is the quintessential example. Much of what feels stressful and depressing at the end of a long day is perceived differently following a good night’s sleep. Good quality sleep is the clincher. Lonely and non-lonely individuals do not differ in the amount of sleep they get, but lonely people have poorer sleep quality than do non-lonely people. They experience more micro-awakenings during the night and they awake feeling more tired and less capable of meeting the demands of the day. Poor sleep has been associated with elevated blood pressure and cardiovascular mortality, and this may help to explain the poorer health outcomes of chronically lonely individuals. In short, lonely days extend into the nights and lessen the restorative nature of sleep.
Loneliness and Health: It’s Not Just Peripheral
From this sampling of the widespread effects of loneliness on health, lifestyle behaviors, physiological functioning, genetic transcription, and sleep quality, it should be clear that the invisible power of felt isolation has long tentacles that have the potential to influence all of physiology. Not only physical health, but also cognitive health is compromised. Indeed, one of the most sobering findings of recent years is that loneliness places people at risk for impaired cognition and dementia." In a 4-year prospective study of initially dementia-free older adults, the risk of Alzheimer’s Disease was more than
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twice as great in lonely than in nonlonely individuals. In addition, loneliness was associated with lower cognitive ability at baseline and with a more rapid decline in cognition during the 4-year follow-up. Similar results were reported for a sample of 75-85- year-old individuals over a 10-year follow-up.
The effects of loneliness on cognition are evident at an even more fundamental level."' Self-regulation, or the ability to regulate one’s attention, cognition, emotion, and/or behavior to better meet social standards or personal goals, is impaired in lonely individuals. For instance, among young adults, instructions to shift auditory attention from the dominant right ear to the non- dominant left ear resulted in impaired performance in lonely relative to nonlonely individuals. Loneliness also alters emotion regulation. In middle- aged and older adults, loneliness was associated with a diminished tendency to capitalize on positive emotions, and this explained why lonely individuals were less likely than nonlonely individuals to engage in physical activity. Impaired cognitive regulation is evident in experimental studies that manipulate feelings of isolation. Participants who receive feedback that induces a sense that they are doomed to a future of social isolation perform significantly worse on tests of reasoning, behave more aggressively, and choose more tasty but unhealthy foods than other participants who receive feedback indicating a future of social connection or bad feedback of a non-social nature, namely that their future will consist of general misfortune.'* There seems to be something uniquely threatening about the prospect, and the reality, of feeling
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