“…Studies designed to identify the mechanisms underlying the association between loneliness and mortality have found that loneliness is associated with increased hypothalamic-pituitary-adrenocortical (HPA) activity (Adam et al, 2006;Cacioppo et al, 2006;Doane and Adam, 2010;Glaser et al, 1985;Kiecolt-Glaser et al, 1984;Steptoe et al, 2004), altered gene expression indicative of decreased inflammatory control and increased glucocorticoid insensitivity (Cole et al, 2007(Cole et al, , 2011, increased inflammation, elevated vascular resistance, and blood pressure (Hackett et al, 2012;Hawkley et al, 2006Hawkley et al, , 2010bJaremka et al, 2013), higher rates of metabolic syndrome (Whisman, 2010), diminished immunity (Dixon et al, 2006;Glaser et al, 2005;Kiecolt-Glaser et al, 1984;Pressman et al, 2005;StraitsTröster et al, 1994), increased risk for age-related cognitive decline and dementia (Wilson et al, 2007), and increased sleep fragmentation (Cacioppo et al, 2002;Hawkley et al, 2010a;Jacobs et al, 2006;Kurina et al, 2011). Cross-lagged panel analyses have also shown that loneliness has also been associated with changes in psychological states that can contribute to morbidity and mortality, including increased depressive symptomatology (Booth, 2000;Cacioppo et al, 2006Cacioppo et al, , 2010VanderWeele et al, 2011), lower subjective wellbeing (Kong and You, 2013;VanderWeele et al, 2012), heightened vigilance for social threats (Cacioppo et al, 2015b), and decreased executive functioning (Baumeister and DeWall, 2005;Cacioppo et al, 2000;…”