Little is known about the importance of confiding relationships in elderly people. Associations between lack of confiding relationships and depression, lifestyle characteristics, medication use, and contacts with doctors were studied by interviewing a random sample of 235 elderly people aged 75 years and over registered with nine general practices in inner London. It was found that men were not significantly more likely than women to report lack of confiding relationships. Married people of both sexes were more likely to have confiding relationships than those who were single, separated, divorced or widowed. Depression was not associated with lack of a confiding relationship, but those lacking such relationships were significantly more likely to smoke, and were prescribed significantly more medicines than those with confiding relationships. Individuals without a confiding relationship were significantly less likely to admit to any alcohol consumption in the previous three months, suggesting that alcohol consumption in this age group is largely a social phenomenon. Confiding relationships do not appear to confer strong protection against depression and a question on confiding relationships should not therefore be routinely incorporated into surveillance programmes for elderly people in the community.