We read with interest the article by Perissinotto et al titled “Loneliness in Older Persons: A Predictor of Functional Decline and Death.”1 The authors state that loneliness “is not adequately captured by quantitative measures of social isolation.”1(p1082) Indeed, it is likely that the elderly persons living in isolation are in better health conditions and have a lower death rate than those living with others. From a medical point of view, they may, in fact, be considered a selected population, able to face life difficulties with a relative independence from the environment. In other words, they are socially isolated, but not psychologically lonely.