Population aging implies specific challenging when looking for the wellbeing of elderly. Loneliness is an issue of increase relevance in research and public policies related to old age and aging, due to its relation to a life stage associated to social losses and is influence in the mental health of the elderly. This essay tries to reflect about loneliness in old age from different rationalities of the concept, as category of cultural and epidemiological classification and the implication it may have in the definition of public policies and strategies to approach the issue. The relation to a rationality of loneliness built from the culture of risk and damage subjectivity is emphasized over the medicalization of the issue as disorder or epidemiological risk factor. Finally, the consideration of building cultural stages to rationalize loneliness in old age is proposed and considerations to measure and approach the issue in the rational framework of cultural epidemiology are discussed.