Thousands of elderly people who live alone in Tokyo have little social contact and face the prospect of a lonely death, according to a survey by an association of hospitals published this week.

Tokyo is home to some 2.3 million people over the age of 65, and according to the Tokyo Min-Iren association, more than 30 percent of them live alone and need urgent help, the regional Tokyo Shimbun said on Wednesday.

The survey of almost 2,000 people aged 65 or over in the capital last year found 37 percent had little or no contact with their neighbours and 30 percent almost never went out, except to buy food or visit the doctor.

“The government and people must do something urgently about this problem,” the paper quoted the association as saying.

One in four elderly men who lived alone said they had no one to consult over problems or fears.

The health of senior citizens varies widely with income, according to the survey. Almost 49 percent of those with an income of less than 50,000 yen ($409) a month said they were in poor health, compared with about 36 percent of those with an income of 300,000 yen or more a month, the paper said.

Japan has the world’s highest proportion of elderly to the population as a whole, and many experts have expressed concern about the fate of the urban elderly, who often have fewer social ties than their rural counterparts.