How loneliness stresses the immune system from inside out

Lonely people experience stress more deeply than socially connected individuals, and it suppresses their immune system. A new study from Ohio State University, Comprehensive Cancer Center, the National Institutes of Health, and the American Cancer Society, suggests loneliness can lower the body's immune system. The latest research links loneliness to a number of dysfunctional immune responses, suggesting that being lonely has the potential to harm overall health.

Check out the January 20, 2013 news LiveScience and Yahoo news article by Stephanie Pappas, "Loneliness Is Bad for Your Health, Study Suggests," and the January 19, 2013 news release by by Emily Caldwell from Ohio State University,, "Loneliness, like chronic stress, taxes the immune system."

New research published presented by the Society for Personality and Social Psychology links loneliness to a number of dysfunctional immune responses, suggesting that being lonely has the potential to harm overall health. If close friends are too difficult to find, can anything else substitute that has a positive affect on the immune system and is capable of de-stressing, such as meditation or even a robot therapy dog if the individual is unable to care for a pet?

Do the lonely have more facial herpes outbreaks such as cold sores?

Researchers found that people who were more lonely showed signs of elevated latent herpes virus reactivation and produced more inflammation-related proteins in response to acute stress than did people who felt more socially connected. These proteins signal the presence of inflammation, and chronic inflammation is linked to numerous conditions, including coronary heart disease, Type 2 diabetes, arthritis and Alzheimer's disease, as well as the frailty and functional decline that can accompany aging.

Notice how often at holiday times, people get cold sores on their lips that may have been dormant for years. Similar herpes outbreaks of cold sores also happen just when someone's seasonal dental or medical appointment is coming up, as if the stress from anticipation of the examination and being in a place you'd rather not be in at the moment puts a damper on the immune system.

Reactivation of a latent herpes virus is known to be associated with stress, suggesting that loneliness functions as a chronic stressor that triggers a poorly controlled immune response.

"It is clear from previous research that poor-quality relationships are linked to a number of health problems, including premature mortality and all sorts of other very serious health conditions. And people who are lonely clearly feel like they are in poor-quality relationships," said Lisa Jaremka, a postdoctoral fellow at the Institute for Behavioral Medicine Research at Ohio State University and lead author of the research, according to the January 19, 2013 news release, "Loneliness, like chronic stress, taxes the immune system."

"One reason this type of research is important is to understand how loneliness and relationships broadly affect health. The more we understand about the process, the more potential there is to counter those negative effects – to perhaps intervene. If we don't know the physiological processes, what are we going to do to change them?"

The results are based on a series of studies conducted with two populations: a healthy group of overweight middle-aged adults and a group of breast cancer survivors. The researchers measured loneliness in all studies using the UCLA Loneliness Scale, a questionnaire that assesses perceptions of social isolation and loneliness. Jaremka presented the research on January 19, 2013 at the Society for Personality and Social Psychology annual meeting in New Orleans.

The researchers first sought to obtain a snapshot of immune system behavior related to loneliness by gauging levels of antibodies in the blood that are produced when herpes viruses are reactivated.

Participants were 200 breast cancer survivors who were between two months and three years past completion of cancer treatment with an average age of 51 years. Their blood was analyzed for the presence of antibodies against Epstein-Barr virus and cytomegalovirus.

Both are herpes viruses that infect a majority of Americans. About half of infections do not produce illness, but once a person is infected, the viruses remain dormant in the body and can be reactivated, resulting in elevated antibody levels, or titers – again, often producing no symptoms but hinting at regulatory problems in the cellular immune system.

Lonelier participants had higher levels of antibodies against cytomegalovirus than did less lonely participants, and those higher antibody levels were related to more pain, depression and fatigue symptoms. No difference was seen in Epstein-Barr virus antibody levels, possibly because this reactivation is linked to age and many of these participants were somewhat older, meaning reactivation related to loneliness would be difficult to detect, Jaremka said.

Previous research has suggested that stress can promote reactivation of these viruses, also resulting in elevated antibody titers

"The same processes involved in stress and reactivation of these viruses is probably also relevant to the loneliness findings," Jaremka explained in the news release. "Loneliness has been thought of in many ways as a chronic stressor – a socially painful situation that can last for quite a long time." In an additional set of studies, the scientists sought to determine how loneliness affected the production of proinflammatory proteins, or cytokines, in response to stress. These studies were conducted with 144 women from the same group of breast cancer survivors and a group of 134 overweight middle-aged and older adults with no major health problems.

Loneliness may be a chronic stressor

Baseline blood samples were taken from all participants, who were then subjected to stress – they were asked to deliver an impromptu five-minute speech and perform a mental arithmetic task in front of a video camera and three panelists. Researchers followed by stimulating the participants' immune systems with lipopolysaccharide, a compound found on bacterial cell walls that is known to trigger an immune response.

In both populations, those who were lonelier produced significantly higher levels of a cytokine called interleukin-6, or IL-6, in response to acute stress than did participants who were more socially connected. Levels of another cytokine, tumor necrosis factor-alpha, also rose more dramatically in lonelier participants than in less lonely participants, but the findings were significant by statistical standards in only one study group, the healthy adults.

Researchers studied breast cancer survivors who felt lonely and experienced more stress

In the study with breast cancer survivors, researchers also tested for levels of the cytokine interleukin 1-beta, which was produced at higher levels in lonelier participants. The key is that the lonely feel stress more deeply and respond with their immune systems, as if the cells have a brain of their own. When the scientists controlled for a number of factors, including sleep quality, age and general health measures, the results were the same.

"We saw consistency in the sense that more lonely people in both studies had more inflammation than less lonely people," Jaremka said, according to the news release. "It's also important to remember the flip side, which is that people who feel very socially connected are experiencing more positive outcomes," she said. The only issue for older adults in isolation is that it's difficult as one ages to feel connected socially unless when is able to make friends easily, especially in an era where trusting strangers is scary for many people, and family may not be available or may have distanced themselves from the aging person.

This work was supported by grants from the National Institutes of Health, the American Cancer Society Postdoctoral Fellowship and a Pelotonia Postdoctoral Fellowship from Ohio State's Comprehensive Cancer Center. Co-authors include Christopher Fagundes of the Institute for Behavioral Medicine Research (IBMR); Juan Peng of the College of Public Health; Jeanette Bennett of the Division of Oral Biology; Ronald Glaser of the Department of Molecular Virology, Immunology and Medical Genetics; William Malarkey of the Department of Internal Medicine; and Janice Kiecolt-Glaser of the Department of Psychiatry, all at Ohio State. Bennett, Glaser, Malarkey and Kiecolt-Glaser are also IBMR investigators.

Jaremka's talk, "Loneliness and Immune Dysregulation: A Psychoneuroimmunological Approach," is part of Symposium S-G4, "Biological Underpinnings of Social Interaction: Interdisciplinary Approaches," that was presented on Saturday, Jan. 19, 2013 in Room 206-207, Ernest N. Morial Convention Center, New Orleans.

The lonely experience more reactivation of latent viruses in their systems than the well-connected

Lonely people also are more likely than others to produce inflammatory compounds in response to stress, a factor implicated in heart disease and other chronic disorders. Breast cancer survivors also were studied. Can loneliness lead to a host of chronic diseases from heart disease and diabetes to cancer and infections? The issue is that loneliness may kick the immune system is a little out of whack.

There's such a condition known as "the lonely body." It's a feeling of disconnectedness. Parents whose culture and faith is very different from their children and grandchildren who keep away from social contact with relatives who are elderly feel the disconnectedness, perhaps reminiscing on past choices and how could it would have been if the person chose another path when young. Old age brings a feeling of regret to some for mistakes chosen and integrity to others who feel 'blessed' by a close-knit family.

Poor health may be linked to immune system problems because of loneliness. Then again, some people have social anxiety or have been so betrayed or hurt by people they've met that they feel more relaxed when alone. Others stay away from people because they can't eat in public, go out at night due to lack of public transportation or fear of riding in cars with strangers, or who just don't know how to make friends, especially after middle-age passes.

Studies have shown that those friendless at age 35 may also be found friendless at 55 and at 75. Others don't know which group to join to make friends or feel like an outsider due to something in their background or even their ethnic origin.

Feeling socially disconnected is associated with poor health and chronic disease

Loneliness, especially at holiday times or times that usually are celebrated by families visiting may trigger the immune system to produce antibodies, or protective proteins that help the immune system hunt down the rogue viruses. Higher antibody levels indicate higher levels of activated virus. The participants also filled out questionnaires about their loneliness and social connectedness. [7 Personality Traits That Are Bad For You], according to the article, "Loneliness Is Bad for Your Health, Study Suggests."

If you look at the results of the study, scientists found that the lonelier the participant, the higher the levels of cytomegalovirus antibodies in the blood. The question for researchers is why is the immune system compromised? Why does loneliness weaken the immune system so that it can't keep viruses latent? And to people who enjoy solitude and don't feel lonely or isolated, but who are friendless, also have the same immune system antibody reactions whether the infection shows up or is not noticed?

What happens to the immune systems of those who prefer solitude?

Do people who enjoy being alone (possibly due to fear of people) also have the same immune system responses? What about people who express "the joy of solitude?" Could it be humans are hardwired in their cells to be social with others?

And do pets take the place of people in the lives of lonely people, such as dogs or cats and change their immune systems? Researchers need to study the immune systems of people in nursing homes or living isolated in homes who are never visited by friends and family but have pets to see whether they have the same antibody response.

The second study looked at breast cancer survivors

The researchers also triggered the participants' immune systems with a harmless compound from bacterial cells before taking a second blood sample. In the study, The lonelier the person, the higher the levels of cytokine interleukin-6 after a stressful speech. This cytokine is important for healing in the short term, because it promotes inflammation. When cytokines react too readily, inflammation can be harmful. Chronic inflammation has been linked to coronary heart disease, arthritis, Type 2 diabetes and even suicide attempts.

Researchers associate chronic stress, with loneliness. The opposite of loneliness is connected relationships. But what if connectedness causes anxiety in some people who feel because they're elderly the strangers who could be friends, but are much younger only want to scam them out of their money at a time when they're weak, aged, and isolated? The thought of friends betraying some people also can be stressful.

One example are when strangers (including neighborhood children) keep coming to the door of an elderly, friendless person's house to sell something, ask for money, make fun of the old person's appearance, or give out information about a religion they don't want to join or donate money? Is this the reality of social connection in modern times? It's easier to make friends when young. But when people are lonely at any age, they react with more inflammation and weaker immune systems to negative events which is experienced at a higher level of stress.

Loneliness and stress

It's more stressful to be disrupted when lonely than when connected to a social network of close friendships or family members who feel close to the individual. Basically, lonely people experience life more stressful than people who are not lonely. The question is can a person who prefers solitude as relaxing for meditation de-stress from staying away from people, that is new people or strangers who could become potential friends or potential abusers? The outcome is that those who act more strongly to negative events at the cellular level, usually are more lonely. Chronic stress disrupts the immune system.

It's too difficult for many people to find close friends, especially older adults who lack public transportation and don't drive, and especially when social groups meet at night or after sundown. The research question to answer is to find out how loneliness leads to sickness or poor health in general.

Right now the treatment numerous scientists may focus on are not solely social ways to disrupt the links between stress and loneliness leading to chronic illnesses. You have robot therapy dogs, for example, in some nursing homes, which people interact with, including people who are never visited by family members. Those who fund research on loneliness and stress which leads to illness are focused mostly on hoping the scientists will develop treatments.

The isolated person may see those 'treatments' as more prescription drugs used to "quiet down" seniors who complain or wander, when their illness in the first place may be reactions to various drugging down to keep them relatively invisible, if diagnosed with dementia or other problems, for example. The outcome for research is to hopefully find treatments that "disrupt the links." Too many people think of loneliness of the older, never visited person as a burden the young have to bear. But is loneliness a burden if solitude is chosen over contact with many strange or 'new' people in public places?

It's difficult for many people to feel close to family and friends if old friends and family members are thousands of miles away, and the older person can no longer travel to reunions. On the other hand, hearing from people who are socially connected in a relationship to the lonely person can make the isolated person feel better or more uplifted.

Society says that those who feel socially connected are experiencing more positive health outcomes. But there needs to be in society a substitute that's not a prescription drug that can do the same for the isolated, friendless person, especially the older person without family contacts. Also check out a new study, "Which nutritional factors help preserve muscle mass, strength and performance in seniors?"

Can robot therapy dogs take the place of friends for some rarely visited isolated Sacramento seniors?

Do Sacramento women over age 70 tend to favor more affordable robot dogs for senior citizens? Some nursing homes report that lonely seniors prefer dogs to people. When your own pet passes over the rainbow bridge, and you're too frail to properly care for a real dog, can a robot dog fill the loneliness that comes when you lose your pet of many years?

Studies have shown that in the eyes of older adults, there was no statistical difference between whether the real or robotic dog did a better job easing loneliness and fostering attachments, according to the news article, Robotic Dog Makes Nursing Home Residents Less Lonely. A reprint of this St. Louis University article also appeared in the Sacramento Bee early in July, 2010.

Wouldn't it be great if robot dogs were sent to war instead of putting real dogs in harm's way? Check out the December 1, 2010 Sacramento Bee article, Labradors, handlers train for war in Afghanistan. According to that article, the dogs are all pros, some champion retrievers, purchased for an average of $10,000 each, and trained and retrained to do one thing: find bombs in Afghanistan.

Wouldn't you rather see a robot dog do that job, a dog whose parts can be replaced as easily as interchangeable computer peripherals instead of real dogs, however well trained? Real dogs shouldn't have to go to war to sniff out bombs. Robot dogs can be trained to do the sniffing, or can they? A real dog can sniff out bedbugs or bombs. But why endanger a real dog? If scientists can create realistic robots, why not invent a robot whose sense of smell is superior to a dog's?

When a dog is important to you, but you're too old to bend down and give that large dog a bath, or you live too far from the veterinarian to walk and mobile vets are too expensive what do you do? Those who long for a wagging tail and a furry animal to pet may buy stuffed toy animals. But even furry toys also shed and collect dust mites. Some people are allergic to the fur on toys.

Robot therapy dogs in nursing homes

The robot dogs have no fur, but they wag their tails. Local and national media are exploring robot dogs for seniors and the medical studies with robot dogs in nursing homes. At any age, if you're looking for a robot dog, you can follow the media reports on news about robot dogs or check out the database at the electronic pets site, electronic pets.org. See the newspaper article, Robotic Dog Makes Nursing Home Residents Less Lonely.

Where can you buy a robot dog? Sony pulled the plug on its older version of AIBO that sold from 2004-2006 for close to $1,300, but what will the new AIBO look like when it comes out in the future? Yet local and national articles keep appearing in the media about how happy a group of senior citizens at a nursing home are upon seeing and petting the robot dog.

It comes from Japan and is called AIBO. That stands for Artificial Intelligence Robot. It's not a toy, it's a robot dog. It's name is similar to IBO, which in Japanese means a pal, a true companion. The robot has friendly dog emotions and dog instincts of the type you want to see. And you don't have to clean up after the dog. You train or program the dog by talking to it.

The robot dog develops into a mature, fun-loving dog friend as time passes. And the robot dog is a friend for your life. For further information, check out the robot dog's website, AIBO Life.org, where you can find your own relatively 'immortal' dog friend.

See the article, "Sony may be planning to release updated Sony AIBO Robo-dog." Here is a detailed review of the newly designed Sony AIBO robo-dog. Sony gave the AIBO a brand new paintjob and new technological features.

The latest Sony AIBO model will be able to interface wirelessly with both your PSP and PS3. You will also notice that the AIBO has a built in headcam that allows the robotic dog to use motion sensor technology and do facial recognitions.

Sony's AIBO will also be able to stream its point of view video over WiFi technology that connects to your computer system. For older adults who really need a robot dog when they are not able to care for a live dog, but need the companionship of a friend who doesn't disagree and who cuddles and is relatively ageless, will older adults who need this robot dog most be able to handle the programming or training with computers? Yes.

Even if you are not online or have never worked on a computer, Sony has made it so you can also control the functions of your AIBO whenever you want. All you have to do is turn on your remote control and it will trigger technology in the robotic dog. Most older people know how to press a remote control and watch TV. If so, they can master the robot dog companion.

The dog will be able to be controlled by the remote. With this step, using a remote control, you now can control the dog's movements. Also, you can use the robot dog as a guard dog. Just set the dog in front of your locked door for the evening.

The Sony AIBO robo-dog will "guard" your house. The dog has a setting you can put the robotic dog on. It is going to use face recognition software to know when it should alert you of a potential intruder. Burglars would probably just ignore the robotic dog. But would it make criminals think twice about coming into your house, store, or junkyard?

Before you buy a robotic dog for the senior citizen in your life, it's not yet released by Sony. The information is being publicized about the new features on the robot dog right now to get a picture of what people are interested in as far as features they want in a robot dog.

The original AIBO didn't sell to as many senior citizens or anyone else as Sony would have wanted. But the new version will be coming out in the near future. Adjustments are being made. Will the dog be affordable?

The original AIBO was too expensive for the average senior citizen who wants a companion dog that doesn't get sick or need to be fed, but still acts just like a real dog. If the price is low enough, a lot of people will buy a robot dog. If you live in an apartment that doesn't allow pets, AIBO is great. If the price comes out too high this time around, the people who need a robot dog most won't be able to afford it.

The best bet to sell a lot of AIBO robot dogs is to aim at families that have older adults who can no longer care for a living pet, usually because they can't bend down to feed or wash the dog or are unable to take the dog for healthcare or on long walks, even with a wheelchair. With a robot dog, it's not alive, but it will have the emotions of a friendly dog. Keep posted on the robot dog also at the gamespot.com.

According to Wikipedia, the original designs are part of the permanent collections of MOMA and the Smithsonian Institution. The design won SONY and artist Sorayama the highest design award that may be conferred by Japan.

On January 26, 2006 Sony announced that it would discontinue AIBO and several other products as of March, 2006 in Sony's effort to make the company more profitable. It will also stop development of the QRIO robot. AIBO will still be supported until 2013 (ERS7 model support breakdown), however, and AIBO technology will continue to be developed for use in other consumer products. [See the site.] [And check out how AIBO technology will be continued in the future.]

You Can Still Attend the Annual AIBO Conventions

The International AIBO Convention takes place every year at Sony Robotics Tower in the Shinjuku prefecture. The first convention took place in 1999, on May 15. It was then set to May 2 to May 4. The 2009 convention, being in its tenth year, set attendance records. Check out what happens each year at the sites, International AIBO Convention‎ and AIBO Dog by Kristen Robertson on Prezi.

Now the question is whether being "in rapport with a robot dog" or other robot can take the place of connectedness to family and friends at the cellular level. Will the immune system react if a substitute for a real human is there? Will the human body know the difference at the molecular level where the immune response happens? That remains to be seen if a different type of study takes place looking at chronic stress, inflammation, and the use of robot pets or real pets with people able to care for them.

AIBO Dog is a robot dog designed and created by Sony The 'dog' Sony came out with in 1999 was discontinued in 2006. Is a robot dog one solution to loneliness for people who simply don't know how to connect with people because they're home or institution or assisted-living based and still isolated, sometimes due to lack of transportation? AIBO Dog is actually targeted to people of all ages.

AIBO Dog is supposed to simulate a real dog. There's also the RoboCup that's specially designed for AIBO dogs to play soccer. Check out the International AIBO convention that takes place every year at Sony Robotics Tower in the Shinjuku prefecture in Japan.

The first convention took place in 1999 on May 15. In 2009 they marked their tenth year. At this convention they set attendance records. Check out the Wikipedia sites on therapy robots. Also see the robot books site, the CNET robots site, the Robots.com site, or the Sony site under "Aibo Dog." Some tasks that Aibo Dog is able to do are walk, "see" via camera, and recognize commands that you would give a normal dog.

Every year there is an International AIBO convention at the Sony Robotics Tower in Shinjuku Prefecture, Japan. At the convention people swap AIBO open-source software and let the AIBOs get together to meet with their brothers and sisters. The convention usually features AIBO advertisements, free posters, free accessories, freeware/open-source downloads, an acoustic performance from best friends Mark Linn-Baker and Larry Sweeney, and "AIBO Shows." At these conventions you can find out when the various robot owner's latest Sony's robot dog will be appearing in public.

AIBO's personality develops by interacting with people and each AIBO grows in a different way, based on its individual experiences. AIBO has instincts to look for its toys, to satisfy curiosity, to play with its owner, to self charge when its battery is low and to wake up when its had enough sleep or been scheduled to do so.

If only the new model would be covered more in the media. Once in a while, you see in newspapers a large photo of a group of seniors in a nursing home surrounding the robot dog. But what readers would like to see is when the latest model will be coming out and how much will it cost.

Why is the cost double that of a live dog there to ward-off loneliness in people?

As far as media and culture, basically, you have robot companions in science fiction since the days of "Twilight Zone." In reality, the people needing a robot companion such as a dog are those who usually find themselves invisible in society, older people with little energy who enjoy petting therapy dogs.

Just like real dogs, robot dogs provide pet therapy. And people who usually say they are afraid of aggressive dogs or constant barking can enjoy the fair weather side of dog emotions without the veterinary and food costs over a lifetime.

The secret life of robot dogs is that they don't grow old and go away

They just interchange parts. That's what's covered in the media, that love can exist between a robot animal and a human, basically, because there's no separation anxiety. If you need a robot dog now for kids between the ages of 4 and 8 or so, Amazon.com sells online Wrex the Robotic Dog. It's not the same as the advanced version for adults of AIBO, but kids like it.

Robotic animals are powerful prescriptions for the lonely older adult. In one St Louis, MO study, to test whether residents connected better with Sparky or Aibo, researchers divided a total of 38 nursing home residents into three groups. All were asked questions to assess their level of loneliness. See the articles based on the studies, Lonely seniors prefer dogs to people, and Dogs help canine-loving nursing home residents feel less lonely.

Robotic therapy animals in nursing homes fight loneliness

One group saw Sparky once a week for 30 minutes, another group had similar visits with Aibo, and a control group saw neither furry nor mechanical critter, according to the article, Robotic Dog Makes Nursing Home Residents Less Lonely. During visits in the St. Louis study, researchers brought real dog, Sparky or robot dog, Aibo into a resident's room and placed the pet companion near the resident. Both pets interacted with residents -- wagging their tails and responding to the people they visited.

After seven weeks, all residents were asked questions about how lonely they felt and how attached they were to Sparky or Aibo. The residents who received visits from real and artificial pooches felt less lonely and more attached to their canine attention-givers than those who got visits from neither.

There was no statistical difference between whether the real or robotic dog did a better job easing loneliness and fostering attachments. So, for your own health benefits, ask whether you need a robot dog, and choose one that works just like a real dog as far as emotions and trainable instincts. The only pleasure missing would be watching the dog wolf down favorite foods.

For feeding time, you'll need a live dog. One advantage of robot dogs is they don't eat or eliminate. Someday robot dogs will be alive, and that's why science fiction usually becomes techno-fact eventually. It's media creating culture, science fiction creating reality in due time. Whenever a person is lonely and needs a dog companion, now there's a choice: living or robotic dogs. It's all in the dog's emotions.

The research needed is what substitute besides a pill to quiet down complaints or 'wandering' of the elderly who don't have a severe dementia where they can't find their way back home, can be made if people aren't able to find close relationships and visiting strangers aren't connected close enough for one's immune system to respond favorably?

Advertisement

, Sacramento Healthy Trends Examiner

Nutrition, health, and media culture writer, Anne Hart is the author of more than 4,000 online articles, 91 paperback books, including numerous novels, and holds a graduate degree in English/creative writing.

Today's top buzz...