Social isolation is associated with a higher risk of death in older people regardless of whether they consider themselves lonely, research suggests.
A study of 6,500 UK men and women aged over 52 found that being isolated from family and friends was linked with a 26% higher death risk over seven years.
Whether or not participants felt lonely did not alter the impact of social isolation on health.
Age UK says cuts to services for older people are compounding the problem.
It is not the first time that loneliness and social isolation has been linked with poor health.
But researchers wanted to find out if it was the emotional aspect of feeling lonely that was having an impact or the reality of having little social contact.
Those who were socially isolated - that is had little or no contact with friends or family - were more likely to be older and unmarried and have long-standing illnesses limiting their mobility, such as lung disease and arthritis.
People who described themselves as feeling lonely were more likely to be female and have a wider range of health conditions, including depression.
Both social isolation and feeling lonely were associated with a higher chance of death.
But after adjusting for factors such as underlying health conditions, only social isolation remained important.
That risk did not change when researchers added in whether or not someone felt lonely in their isolation.
Writing in the Proceedings of the National Academy of Sciences, the researchers said they were surprised by their findings.
Study leader Prof Andrew Steptoe, director of the Institute of Epidemiology and Health Care at University College London, said: "Social connections can provide emotional support and warmth which is important but they also provide things like advice, making sure people take their medication and provide support in helping them to do things.
"It would suggest that those practical aspects are quite important for older people's survival.
"There's been such an increase in people living alone. In the last 15 years, the number of 55 to 64-year-olds living alone has increased by 50%.
"And it might be that people in those circumstances aren't looking after themselves so well."
Michelle Mitchell, director general at Age UK, said: "This study shows more clearly than before that being lonely and isolated is not only miserable, it is a real health risk, increasing the risk of early death."
She added that cuts to local authority budget cuts may exacerbate the problem of isolation for many older people.
"Across the country day care centres, often the only regular social life that many older people enjoy, are closing, social care support which can enable older people to leave the house is being cut down to the bare minimum, and too many older people are hidden behind closed doors struggling to cope."